KR20210024603A - Improvements in methods and apparatus for removal of skin pigmentation and tattoo ink - Google Patents

Abstract

Methods and apparatus for dermatological laser treatment, such as for the removal of unwanted tattoos or other skin pigmentation. Removal of multiple colors with a single pulsed laser beam can be achieved using intensities in excess ^{of about 50 GW/cm 2.} Methods for reducing pain and tissue damage associated with laser tattoo removal include using a spot size of less than 2 mm with a fluence ^{between 0.5 and 10 J/cm 2.} Scanning a laser beam over an area of the skin to be treated allows these areas to be accurately treated with scanning patterns calculated to promote rapid dissipation of heat away from the treated areas of the skin. Multiple treatment rooms may be provided by a single pulse treatment laser with beam toggling, splitting or pulse-peaking to minimize laser downtime.

Description

Improvements in methods and apparatus for removal of skin pigmentation and tattoo ink

The present invention relates to the removal of unwanted skin pigmentation and tattoo ink and encompasses various improvements in and related to methods and apparatus therefor.

Tattooing and other pigmentation of the skin involves the placement of pigments into a layer of dermal tissue beneath the dermis of the skin, i. After initial injection, the pigment is dispersed throughout the damaged layer, homogenized down through the epidermis and upper dermis, and the presence of foreign matter on both sides activates the immune system's phagocytic cells to suck up the pigment particles. As healing progresses, the damaged epidermis peels off (removes the surface pigment) while forming granulation tissue deeper in the skin, which later turns into connective tissue by collagen growth. This fixes the upper dermis, where the pigment ultimately remains trapped in successive productions of macrophages, gathered in a layer just below the dermal/epidermal boundary at a depth below the skin surface between about 300 and 700 μm. Its existence is stable, but over the long term (decades), given the degraded detail of old tattoos, the pigment tends to migrate deeper into the dermis. According to the 2016 Harris Poll (2016, Shannon-Missal), almost half of people aged 18 to 36 in the United States have tattoos, and nearly one in four regrets it. Based on an estimate of about 60 million people in this age group, this means that about 7.5 million people have "tattoo regrets". Therefore, many people with tattoos want to get rid of them.

In this application, the gold standard modality for tattoo removal is the non-invasive removal of tattoo pigments using Q-switching lasers. The application of radiation to the subject's skin is done manually: the operator aims the laser beam at the area to be treated and shoots the laser. Different types of Q-switching lasers are used to target different colors of tattoo ink depending on the specific light absorption spectra of the tattoo pigments. Typically, black and other darker-coloring inks can be completely removed using Q-switching lasers, but lighter colors such as yellows and greens are very difficult to remove. Success can depend on a wide variety of factors including skin color, ink color, and depth to which the ink is applied.

Pulsed laser treatment is also used to remove unwanted skin pigmentation and pigmented lesions, such as freckles, age spots, black spots, brown spots, melasma and burgundy spots, and epidermal vascular anomalies such as telangiectasias. do.

Laser removal of unwanted pigmentation typically results in ^{skin surface input intensities of about 10 9} to 10 ¹⁰ W/cm ² and pulse widths greater than 250 ps to achieve fluences ^{of about 1 to 7 J/cm 2.} Is executed using. To calculate these input fluences, pulse energies in the range 200 to 800 mJ are used with 2 to 6 mm spot sizes and ˜1 to 10 Hz pulse repetition rates on the skin surface.

These methods are color-selective and it is assumed that the main interaction of the laser with the tissue, mainly absorption, is only a function of the wavelength on the target pigment absorption. In fact, this is the main idea behind selective ray heat fusion (1983, Anderson & Parrish). It is widely believed that there must be a match between the laser radiation wavelength and the color of the ink or lesion to be removed. For example, red ink can be removed by a green (532 nm) laser, but it is well known that green ink requires an infrared (IR) (800 nm) wavelength. When a mismatch occurs (ie, when an inappropriate laser wavelength is used), the laser radiation is not absorbed by the target color and no removal is achieved. This is particularly a problem when a single tattoo has multiple colors requiring different laser wavelengths. Current advanced laser ablation systems offer a variety of wavelength lasers to accommodate different tattoo colors, but with limited success and high cost. The number of treatments required can range from 8 to 20 and last from 1 to 2 years.

It is therefore an object of the present invention to provide methods and apparatus for the removal of skin pigmentation or tattoo ink, capable of removing a large number of different colors using a single wavelength laser light.

Current tattoo removal treatment systems suffer from several other drawbacks (Goldman, Fitzpatrick, Ross, Kilmer, & Weiss, 2013).

통증은 치료의 필수적인 부분이며 국소 마취들이 일반적으로 적용된다.

Pain is an essential part of treatment and local anesthesia is commonly applied.

피부 손상이 집약적이다. 종창, 압통, 점상 출혈, 물집 및 가려움과 같은 즉각적인 부작용들은 치료의 정상적인, 즉각적인 결과로 고려된다. 극심한 통증, 사지 부종, 진성 출혈, 수포 및 난치성 소양증과 같은 유해 효과들이 때때로 발생할 수 있다. 흉터, 텍스처 변화들 및 비대선 흉터는 급성 또는 만성일 수 있는 다른 가능하고 일반적인 합병증들이다.

Skin damage is intensive. Immediate side effects such as swelling, tenderness, spotting, blisters and itching are considered normal, immediate results of treatment. Adverse effects such as extreme pain, swelling of the limbs, true bleeding, blisters and refractory pruritus can sometimes occur. Scars, texture changes and hypertrophic scars are other possible and common complications that may be acute or chronic.

아주 넓은 손상 때문에, 치료들 간의 회복 시간은 길며, 적어도 6주 이상이 완전한 조직 회복을 위해 요구된다.

Because of the very wide injuries, the recovery time between treatments is long, and at least 6 weeks or more is required for complete tissue recovery.

The above mentioned drawbacks are considered as major barriers for the wide adoption of prior art systems for pigmentation removal.

Another object of the present invention is therefore to reduce the amount of pain and skin damage experienced by a subject when they are subjected to laser treatment for the removal of unwanted skin pigmentation.

Another object of the present invention is to shorten the recovery times between successive laser treatments to allow for more rapid removal of unwanted skin pigmentation.

In addition, the passive application of the laser to the subject's skin is inherently slow and/or inaccurate. The aiming beam is sometimes used to provide positional feedback for the operator, but maintaining accurate performance and high throughput is difficult. When the area to be treated has small features and sizes, such as a complex tattoo or a group of small lesions, the beam size also interferes with the accuracy of the laser treatment. Although using the smallest current beam size at these applications of about 2 mm, it is time consuming and inaccurate to treat areas of features less than 2 mm. In addition, the accuracy of the placement depends entirely on the operator's expertise, skill, experience and patience, all of which can vary considerably. While covering large pigment areas, operators typically use pulsed lasers with a pulse rate of 10 Hz and move the beam very quickly over the area. This is an inherently imprecise process and involves a high degree of inevitable overlap of successive pulses on the skin and accompanying additional damage to the tissue. Therefore, it is clear that the manual placement of laser radiation is inconsistent, inaccurate, time consuming and can exacerbate the damage to the skin caused by these conventional laser treatment methods.

Another object of the present invention is therefore to provide methods and apparatus for the removal of tattoos and other undesired localized skin pigmentation, which is more accurate than previous methods, leading to reduced treatment times and/or reduced tissue damage. It is to do.

Another object of the present invention is to provide methods and apparatus for examining a dermatological laser treatment device to ensure that it operates consistently and reliably within predetermined, safe operating parameters.

Further objects of the invention will be apparent from the following description of the invention, in particular from its technical advantages over existing methods of removing unwanted pigmentation from the skin.

As will be apparent, there are a number of different aspects of the invention that can be used together or separately as required by those skilled in the art. The various different technical problems associated with previous laser-based methods of dermatological treatment discussed above are addressed by different aspects of the present invention. It is not intended that each distinct aspect of the invention will necessarily solve all of the above-mentioned problems on its own.

It has now surprisingly been found that the laser interaction with the pigment or tattoo ink in the skin is not just a function of wavelength, but rather a function of wavelength and/or pulse duration and/or intensity. In particular, increasing the intensity of the laser light to a level of about 10 ¹¹ to 10 ¹² W/cm ² with fluence values similar to those used in the prior art, i.e. about 1 to 7 J/cm ^{2 uses a single laser wavelength.} Thus, it has been found that efficient removal of different colors can be obtained. It has been found that the intensity of the laser light needs to be high enough to work considerably with all colors, especially visible colors. In contrast to the distinct threshold of non-linear optical decay, for pigments in living skin, it has been found that there are a wide range of intensities that can be used to interact with multiple colors using the same wavelength.

In a first aspect of the invention, therefore, a method of dermatological treatment is provided, the method comprising irradiating an area of the skin of a subject to be treated with a pulsed beam of laser light; It is characterized in that the laser light has ^{an intensity of at least about 50 GW/cm 2} and a pulse width in the range of about 0.1 to 100 ps.

Suitably, in some embodiments, pulsed laser light may be produced by a mode-locked laser of a kind known to those skilled in the art.

Within each treatment, the area of the subject's skin to be treated is generally irradiated only once. Typically, the area to be treated is larger than the spot of laser light where each pulse is incident on the subject's skin. Thus, to treat the entire area, the beam can be moved over the area, by moving the beam itself or the area to be treated, as will be explained in more detail below, and thus successive pulses, each portion of which is a beam The laser light produced by hits separate parts of the area, having a size approximately equal to the size of the spot. Each portion of the area receives one pulse of laser light within a single treatment. The distinct portions of the area of the skin irradiated by the pulses within a single treatment preferably do not overlap each other.

Suitably, the pulsed laser light may have a fluence at an epidermal depth ^{of about 0.5-10 J/cm 2.} In some embodiments, the fluence at the depth of the epidermis may be about 1 to 8 J/cm ² or 1 to 7 J/cm ² . Here, the'epidermal depth' refers to the depth at which the pigment is usually located in the dermis, that is, about 200 to 1000 μm below the surface (epidermis) of the skin.

In some embodiments of the invention, the dermatological treatment may be entirely cosmetic and may be, for example, to remove skin pigmentation or tattoo ink, or to treat other skin conditions for non-medical purposes. Skin conditions that can be treated according to the invention include epidermal vascular malformations (wine spots), facial telangiectasia, hemangiomas, purulent granulomas, Kaposi's sarcoma, and vascular lesions including Sivat's polydermatosis.

-Pigmented lesions including freckles and nevus including some congenital melanocyte nevus, blue nevus, Ota/Ito nevus and Becker nevus.

-Facial wrinkles, acne scars, keloids and hypertrophic scars, and sun-damaged skin.

However, in some embodiments, the methods of the present invention may be used for medical purposes. In particular, the methods of the present invention can be used for the medical treatment of skin conditions such as, for example, acne, inflammatory skin diseases, benign and malignant skin tumors.

By "removal" of skin pigmentation, tattoo ink or other skin conditions, it is meant wholly or partially removal. Typically, the lesion or tattoo will not be removed by a single treatment, and the intensity of its pigmentation will be reduced. Complete removal may require multiple successive treatments over a period of time when the color gradually fades after each treatment, as described in more detail herein. Complete clearance (visually) of the color from the skin can be achieved after a limited number of sessions. The number of sessions may vary from one target color to the next, but anyway, the number of sessions from one color to the next will not vary by more than about a multiple of two. As explained in more detail below, an advantage of the methods of the present invention is the ability to perform treatments more frequently for a given individual in order to shorten the total time for complete removal of the lesion or ink.

The use of high intensity pulsed laser light according to the present invention can allow a series of colors of a pigment or ink, in particular visible colors, to be removed using a single wavelength of light. This contrasts sharply with previous methods in which the wavelength of the laser is closely matched to the color of the lesion or tattoo to be removed. In some embodiments of the present invention, the intensity of the laser light may be selected for a given wavelength and fluence to obtain a pigmentation or removal of at least three different colors of the lesion. Colors can be selected from black, green, yellow, red and orange, for example. Advantageously, the intensity of the laser can be selected to obtain the removal of multiple colors including, for example, purple and pink. For a given wavelength, the intensity of the laser light required to remove a plurality of selected colors can be selected empirically by measuring the response threshold of different ink colors/skin pigments while increasing the intensity of the laser light with a constant fluence. By finding the "worst case" color, ie the highest intensity required to remove the color that is most difficult to remove, an appropriate working intensity covering all of the selected colors can be identified.

In some embodiments, the working intensity of the laser light can be selected to introduce sufficient intensity so that all target colors are absorbed/absorbent due to similar non-linear processes of absorption.

Thus, in some embodiments, the laser light may have an intensity ^{of about 0.1 to 1 TW/cm 2.}

According to a particular aspect of the invention, therefore, a method of dermatological treatment is provided, the method comprising irradiating an area of the skin of a subject to be treated with a pulsed beam of laser light; The laser light is characterized in that it has an intensity of at least about 50 GW/cm ^2.

Suitably, the laser light may have a pulse width of at least about 0.5 ps, preferably at least 1.0 ps. In some embodiments, the laser light may have a pulse width of less than about 35 ps, preferably less than about 25 ps. Thus, the laser light can have a pulse width in the range of about 1 to 15 ps, preferably about 1 to 10 ps.

According to a different aspect of the invention, therefore, a method of dermatological treatment is provided, the method comprising irradiating an area of the skin of a subject to be treated with a pulsed beam of laser light; The laser light is characterized in that it has a pulse width in the range of about 0.1 to 100 ps.

Advantageously, the laser light can have a spot size of less than about 2 mm in diameter on the skin. In some embodiments, the laser light is about 0.1 to 1.5 mm; Typically, it may have a spot size of about 0.5 to 1.0 mm. This spot size is smaller than the spot sizes of 2 to 6 mm used in previous methods. For the same fluence, a smaller spot size will necessarily cause less energy to enter the skin compared to a larger spot size. However, for a given fluence, on a somewhat simplified analysis, a pulse of laser light will produce an increase of approximately the same temperature within the volume of skin irradiated by the laser light irrespective of the spot size. (Due to the complex tissue structure and interaction of light, there may be small volumes of higher elevated temperatures). For example, a laser pulse with a fluence of about 2.5 J/cm ² will cause a temperature rise of about 15° C. regardless of whether a spot size of 5 mm or 0.5 mm is used. The advantage of using a relatively low energy small spot size is that the temperature of the skin will drop faster after irradiation compared to a larger spot of relatively high energy.

When the skin undergoes an elevated temperature, there is an inverse relationship between the elevated temperature the skin can tolerate without tissue damage (eg, coagulation) and the length of time the skin undergoes the elevated temperature. Studies have shown that surface temperatures of 44° C. do not produce an image unless the exposure time exceeds about 6 hours. At temperatures in the range of 44° C. to 51° C., the rate of epidermal necrosis is approximately doubled for each half degree Celsius. Above 70° C., the exposure time required to cause transdermal necrosis is less than 1 s (Pierce County Emergency Medical Services). These numbers represent the external heat source applied to the skin. In the case of laser radiation that heats tissue from the inside because of the intrinsic pigment absorption, these numbers are likely to be optimistic and damage can occur more quickly.

Appropriately, therefore, the fluence and spot size of each pulse of laser light incident on the subject's skin is ^{within the range of about 0.5 to 10 J/cm 2} of the fluence, and the spot size is that the skin damage occurs at an elevated temperature. It must be controlled to cool sufficiently fast after irradiation, which has not experienced an elevated temperature greater than 44°C for longer than the critical duration.

Accordingly, according to a second aspect of the present invention, a method of dermatological treatment is provided, the method comprising moving a pulsed beam of laser light over an area of the skin of a subject to be treated; Wherein each pulse impinges on a different part of the subject's skin within the area to be treated in the form of a spot, and the fluence of each pulse at the depth of the epidermis is in the range of ^{about 0.5 to 10 J/cm 2;} The size of each spot is characterized in that it allows the skin damage to cool fast enough so that it does not experience an elevated temperature greater than 44° C. for longer than the critical duration that occurs at the elevated temperature.

Suitably, the fluence of each pulse at the depth of the epidermis, as mentioned above, is about 1 to 8 J/cm ² ; Or in the range of 1 to 7 J/cm ^2.

Appropriately, the size of the spot is that the skin's thermal relaxation time (which can be defined as the time it takes for the skin's temperature to drop by half the initial temperature rise) will cause the skin to withstand an initial temperature rise before damage to the skin occurs. It can be made shorter than the possible length of time. In this context it is meant the maximum temperature reached by the skin following the reception of a pulse of laser light by means of an'initial' temperature rise. Typically, the thermal relaxation time may range from about 0.1 s to about 8 s. For example, in some embodiments, the size of the spot generated by the laser light on the subject's skin should be such that the temperature of the skin does not rise above about 51° C. and only provides a relaxation time, or only about 6 s.

As mentioned above, in some embodiments, the spot may have a diameter of less than about 2 mm. In general, the spot can be circular, but in other embodiments, the spot can have a different shape with a maximum diameter of less than about 2 mm.

Accordingly, according to a third aspect of the present invention, a method of dermatological treatment is provided, the method comprising moving a pulsed beam of laser light over an area of the skin of a subject to be treated; Wherein each pulse impinges on a different part of the subject's skin within the area to be treated in the form of a spot, and the fluence of each pulse at the depth of the epidermis is in the range of ^{about 0.5 to 10 J/cm 2;} It is characterized in that each spot has a maximum diameter of less than about 2 mm.

As explained above, each spot may suitably have a maximum diameter of 1.5 mm or 1 mm.

The fluence of each pulse at the depth of the epidermis, as mentioned above, is about 1 to 8 J/cm ² ; Or in the range of 1 to 7 J/cm ^2.

Suitably, the laser light is capable of inputting pulses of energy into the skin in the range of about 1-50 mL. In some embodiments, each pulse can have an energy in the range of about 1-30 mJ. For example, the pulse energy may be about 2.5mJ, 5mJ, 10mJ, 15mJ or 20mJ.

In principle, it can be considered that increasingly smaller pulse energies will yield very fast heat diffusion times. In fact, there is a very strong lower cap for pulse energy. Considering the pulse energy and required fluence for effective treatment, the pulse effective area (spot size) can be calculated as follows:

Area = pulse energy/fluence required

In biological tissue, it is well known that pronounced scattering is caused by irregularities in the index of refraction by different cells, organelles and also macro features such as blood vessels and tissue types. This effect is similar to heat diffusion as it can be approximated by the diffusion effect on the laser beam. The laser radiation, striking the surface of the skin as a small round, uniform spot, begins to diffuse sideways/radially, for example, and can become Gaussian-shaped as it propagates deeper into the skin. The greater the penetration depth, the greater the width of the diffusion and the lower the average fluence. For a given depth and very small (ie narrow) beam, this effect produces a Gaussian "stain" of the typical length scale. As the finite input beam size approaches this length scale, the input fluence at the top of the tissue begins to decrease significantly while propagating downward. This limits the minimum useful spot size and thereby the fastest achievable thermal relaxation time of a single pulse. Suitably, therefore, the spot is at least about 0.1 mm; Typically it may have a diameter of at least about 0.25 mm or other minimum dimensions.

By using the small spot size according to the present invention to allow the temperature of the skin to fall faster after irradiation with pulses of laser light, the level of pain experienced by the subject and the degree of skin damage can be significantly reduced. Not only does this make the process of pigmentation removal more tolerable for the subject, it can also allow for more frequent treatments, thereby accelerating the time it takes to complete removal of a tattoo or other unwanted pigmentation. For example, conventional laser methods of pigmentation removal require rest periods between about 6 to 8 weeks of continuous treatments, but the methods of the present invention require treatments every 1 to 2 weeks; Sometimes it can be allowed to repeat less safely. This represents a significant acceleration of the pigment removal process.

According to a fourth aspect of the present invention, therefore, a method of pigmentation removal is provided, wherein a pulsed beam of laser light is treated such that each pulse strikes a different portion of the subject's skin within the area to be treated. Comprising a plurality of successive dermatological treatments moved over an area of the subject's skin to be treated; Here, each pulse has a fluence in the range of about 0.5 to 10 J/cm ² and a spot small enough so that the skin does not experience an elevated temperature higher than 44°C while the skin damage is longer than the critical duration that occurs at the elevated temperature. Collides with the subject's skin in the form of; The dermatological treatments are repeated every 1-3 weeks.

Within each treatment, an area of the subject's skin may be irradiated such that each distinct portion of the area receives only one pulse of laser light. In some embodiments, several treatments may be performed on the same day, prior to a 1-3 week rest period. Suitably, up to 4 treatments; More typically, 1-3 treatments can be performed on the same day. In some embodiments, two treatments may be performed on the same day.

Suitably, the rest period may be 1 to 2 weeks. In some embodiments, the rest period for a particular subject may be determined by a magnifying glass. In particular, changes to the subject's skin can be observed after treatment to determine when the subject is ready to accept further treatment. Changes to the skin that can be monitored include, for example, spasticity, skin damage and/or skin vascular activity. These techniques are well known to experienced dermatologists.

In some embodiments, the intensity of light may be selected according to the present invention to interact with multiple colors within the visible spectrum. Thus, the laser light may have an intensity in the ^{range of 10 11} to 10 ¹² W/cm ^{2 as described above.} However, according to this aspect of the invention, the lower intensity of the laser light can be used to interact with a single color. In some embodiments, however, the intensity of the laser light may be in the range of 10 ⁹ to 10 ¹⁰ W/cm ² .

The fluence of each pulse at the depth of the epidermis is about 1 to 8 J/cm ² ; Or in the range of 1 to 7 J/cm ^2.

In some embodiments, two or more different wavelengths of laser light may be used in combination for increased efficacy for specific colors of a pigment or ink. Thus, in some embodiments, a first pulsed beam of higher intensity laser light may be used in combination with a second pulsed beam of lower intensity laser light. The first beam may ^{have an intensity of 10 11} to 10 ¹² W/cm ² , but the second beam may have an intensity of 10 ⁹ to 10 ¹⁰ W/cm ² . As explained above, the beams can have the same or similar fluences. For example, each of the first and second pulsed beams may independently have a fluence in the ^{range of 0.5 to 10 J/cm 2, as described above.} For example, it has been found that for some subjects, it may be advantageous to target the red pigment individually from different colors. Thus, in one embodiment, a high intensity infrared (IR) laser may be used in combination with a low intensity green laser. In another embodiment, two IR lasers may be used, one of relatively high intensity and one of relatively low intensity. Suitably, the high intensity IR laser may have a wavelength of 800 nm or 1030 nm. A relatively low intensity IR laser can have a wavelength of 1064 nm. The green laser may have a wavelength of 532 nm. According to the invention, successive pulses of laser light can be applied to separate parts of the area as described above. The beam can be gradually moved over the area to be treated so that each pulse hits a different portion of the subject's skin. If the spots completely filled the area to be treated and the pulse repetition rate was so high that the entire area was covered within a much shorter time than the thermal relaxation time for a single pulse, it would in fact create a single large spot and the heat diffusion would be large, high. It will be similar to the one for the energy spot. However, in some embodiments, it is understood that the present invention incorporates an intentional, designed or controlled spacing between laser spots.

According to the invention, therefore, separate parts of the area of the skin treated with successive pulses of laser light can advantageously be separated from each other by a small distance. Suitably, there may be a controlled spacing between the laser spots. In some embodiments, for example, the separate portions may be separated by at least about 0.1 mm.

In a fifth aspect of the invention, therefore, a method of dermatological treatment is provided, the method comprising moving a pulsed beam of laser light over an area of the skin of a subject to be treated; The beam forms a spot of laser light on the skin of the subject, and successive pulses hit each of the different parts of the area with a fluence at the depth of the epidermis in the range of ^{about 0.5 to 10 J/cm 2, the parts} They are separated from each other by at least about 0.1 mm.

The separate parts can thus correspond to an array of small spots. The advantage of using an array of these small spots slightly apart from each other is that there will be small untreated patches of skin between neighboring spots. In addition to accelerating thermal relaxation and reducing damage, these small patches can be important in significantly speeding up the healing processes of the healed and localized skin. Patches between neighboring spots are not treated within a single treatment, but over a series of treatments, the spots within the area to be treated will not be in exactly the same place during each treatment and untreated patches in one treatment It will be cured in another treatment. Fast healing makes this a favorable tradeoff for the overall treatment time.

Another option according to the invention is to deviate from the uniform circular radiation profile of the incoming laser and introduce a gradient, for example a Gaussian profile. This can ensure that, at the edges of the beam, where the radiation is significantly lower, reduced or no damage occurs, even if adjacent spots cover the entire area of the treatment. Suitably, the beam of laser light may be attenuated in the outer perimeter area such that the intensity of the beam within each spot disappears in the outer perimeter area. For a circular spot, the outer peripheral area may be annular. The intensity within the outer perimeter area can be uniform so that there is a step change in intensity between the outer perimeter area and the rest of the beam. Alternatively, the intensity within the outer periphery area can be graded so that the intensity gradually decreases toward the outside of the beam.

Accordingly, in a sixth aspect of the present invention, a method of dermatological treatment is provided, wherein each pulse generates a spot of laser light in the skin of the subject, and flue in the range of ^{about 0.5 to 10 J/cm 2} Irradiating an area of the skin of the subject to be treated using a pulsed beam of laser light with an ence; The beam of laser light is moved over the area to be treated so that successive pulses hit different parts of the area, and the beam is attenuated so that its intensity is lower in the surrounding outer area than the rest of the beam.

In some embodiments, therefore, the spots of laser light may overlap each other. In some embodiments, laser spots can cover the entire area to be treated.

Another option according to the invention for allowing the heat to dissipate as quickly as possible from each part of the area to be treated irradiated using a pulse of laser light is to allow the heat to dissipate from the treated part so that the immediately following pulses It is to ensure that there is a sufficient time delay between them. In some embodiments, this can be achieved by using a moderately low pulse repetition rate. In this regard, a pulse repetition rate in the range of about 1 to 10 Hz can be used.

In all of these options, the fluence of each pulse at the depth of the skin is about 1 to 8 J/cm ² ; Or in the range of 1 to 7 J/cm ^2.

In some embodiments, pulses of laser light may be directed to the skin in a pattern comprising a plurality of adjacent rows of irradiated spots according to a sequence ensuring that neighboring rows are not irradiated in succession. For example, a series of successive pulses can be directed to the skin in one line (i.e., as a row of spots), and immediately afterwards, an additional series of pulses may cause any of the spots on the other line to be directed to the skin. It can be directed to the skin at another line spaced from one line so that it is not adjacent to any of the spots. This ensures that the heat from the spots of one line has time to diverge in the transverse direction of at least one line. In some embodiments, the area to be treated may be irradiated by moving the laser beam over the area to be treated in a sequence of progressive linear or curved passes, with each pass correspondingly a line of adjacent portions of the area of the skin to be treated. It has a duration of multiple pulses of a laser beam impinging on the skin to treat it. The lines of portions are adjacent to each other to cover the area to be treated. According to the present invention, the sequence of consecutive passes of the laser can prevent adjacent lines from being treated successively. Instead, each successive pass may create a line of spots that are not adjacent to the line immediately preceding the spots; A line of spots adjacent to the previous line can only be made after making one or more non-adjacent lines between them.

Suitably therefore the beam can be scanned over the area to be treated. Laser scanners are readily available with large scanning fields of ^{100 x 100 mm 2} for a 160 mm focal length. The choice of scanner focal length and size is a tradeoff of required scanning field area versus size (weight). The scanning mechanism may be advantageous to use with smaller spot sizes of the kind described above and higher pulse repetition rates as described in more detail below. This can allow for uniform application and fast coverage of the laser spots. In addition, the accuracy of placement can be achieved by automated scanning of the laser beam on the subject's skin. By using a small laser spot, small features on the subject's skin can be accurately treated. Any suitable laser scanning system known to those skilled in the art can be used for this purpose. Embodiments of suitable beam scanning devices are described in more detail below.

In some embodiments, radiation may be delivered to the subject's skin through articulated cancer. The free end of the articulating arm can be held by a robot, xy or xyz stage or any other suitable means with sufficient degrees of freedom to precisely scan the laser beam in synchronization with the pulse rate of the laser and the size of the field required. have. The part of the subject's body in which the area to be treated is located may be held stationary by any suitable device.

In some embodiments, the laser beam itself may be scanned over the area to be treated by means of optical beam steering. Any suitable method of beam steering known to those skilled in the art may be used, such as using galvanometric mirrors or acoustic-optical modulators, for example.

An advantage of this aspect of the invention is that a beam of laser light can be scanned over a configurable area of the subject's skin. The scanned beam may define a scanning field. In some embodiments, the scanning field may have a fixed shape, eg, rectangular or circular. In some embodiments, the shape of the scanning field may be adjustable. For example, the shape of the scanning field may be selectable from a number of pre-set shapes, such as circular, square and rectangular. For example, a number of different rectangular field shapes with different aspect ratios may be provided. As described in more detail below, in some embodiments, the shape of the scanning field may be automatically configurable according to the shape of the area to be treated. The scanning field may have a longest dimension of up to about 10 mm or about 12 mm. Suitably, the scanning field may have a longest dimension of up to about 5 mm. In some embodiments, the field size may be adjustable. The field size may be continuously adjustable, or may be selected from a number of pre-set field sizes, such as 1, 2, 3, 4 and 5 mm.

Suitably, the laser beam can be delivered through the work head. In some embodiments, the scanning field can cover the entire area to be treated. However, in order to treat areas larger than the size of the scanning field, the work head may be movable relative to the area to be treated. For example, in some embodiments, the work head may be carried on the end of an articulating arm of the type described above. The scanner head may be manually movable. In some embodiments, as described in more detail below, the scanner head may be moved automatically. Alternatively, the scanner head may be immobile and the area to be treated may be moved in a controlled manner relative to the scanner head. For example, the subject can be moved relative to the work head by means of the stage. Suitably, the stage can be automated using means similar to those for articulated arms, for example. In this case, the subject, or at least a portion of the subject's body on which the area to be treated is located, is fixed and supported on a support member, such as a movable stage, arranged for controlled movement relative to the work head. Can be.

Advantageously, the work head may comprise a fixed or adjustable length of spacer extending its way from the work head in a direction generally parallel to the direction of the laser beam in use. The spacer may suitably comprise an elongated member extending juxtaposed to the therapeutic laser beam without blocking it. For example, the elongated member may comprise a finger-shaped member or a tubular or quasi-tubular member surrounding the laser beam. The elongate member may have a smooth distal end away from the word head for contacting the subject's skin. The spacer thus acts to keep the work head at a constant distance from the area of the skin to be treated. Suitably, the spacer is removable from the work head. The spacer member may be disposable or washable so that a clean, sterile spacer can be used for each subject to be treated.

A further advantage of scanning a large number of small spots according to the invention is that the overall shape of the scanned area can be controlled to optimize the treatment. In previous methods, a single, large spot is typically round or rectangular, and its overall size can be controlled, but its shape is not. Conversely, in some embodiments of the present invention, the scanning area or scanning field can be programmed into any desired shape. The scanning field may have a selectable “brush” size and/or shape that can be adapted according to the shape of the area to be treated. This may be advantageous for scanning elongated shapes, for example, to remove long and thin tattoo lines, such as text characters, which typically have many horizontal and vertical lines. Within the scanning field, the corresponding portion of the area of the subject's skin is quickly irradiated once. If necessary, the scanning head can then be moved to another portion of the area to be treated or the like as described above until the entire area is covered. Compared to using only small round or square spots, the throughput advantage can be significant.

The present invention thus understands the use of any (brush) type of scanning pattern for optimizing treatment efficacy and minimizing treatment duration by taking into account the shape of the target area for treatment. A further advantage of the adjustable size and shape of the scanning field is the ability to minimize the lasing of tattoo-free or unpigmented skin to reduce secondary tissue damage and thus reduce healing time.

Suitably, the visible aiming beam outlines the scanning field, thereby helping the operator to guide the laser beam over the area to be treated in the manner described above, defined by the treatment beam, for example by scanning. It can be continuously directed around the perimeter of the scanned beam. It will be appreciated that the aiming beam should not have any effect on the subject's skin and only act to provide a visible indication on the skin of the location of the treatment beam. Once the operator is satisfied that the scanning field is accurately positioned relative to the subject's skin, they can selectively operate the pulsed laser beam to scan across the field.

Those skilled in the art will understand that any combination of the above-mentioned techniques can be used to scan a laser beam over an area to be treated.

In some embodiments, smart scanning technology may be used to ensure maximum delay between irradiation of neighboring parts of the subject's skin, thereby reducing the thermal load. Thus, the beam is directed to the area to be treated or the scanning field with a configurable scanning pattern that reduces the thermal load by skipping a portion of the area to be scanned immediately adjacent to the scanned portion and scanning portions further away from the scanned portion and then returning it. Can be scanned across. Suitably, the beam can be scanned over the area to be treated as a series of linear or curved lines.

Accordingly, in a seventh aspect of the present invention, a method of dermatological treatment is provided, wherein each pulse generates a spot of laser light on the skin of a subject, and flue is in the range of ^{about 0.5 to 10 J/cm 2.} Irradiating an area of the skin of the subject to be treated using a pulsed beam of laser light with an ence; The beam of laser light is scanned over the area to be treated in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated.

In some embodiments, the beam may be scanned over a scanning field of the kind described above. The lines can be scanned parallel to each other to cover the area to be treated, or the scanning field. Each line may comprise a plurality of successive pulses of laser light to adjacent portions of the subject's skin, which may or may not overlap as described above. Suitably, adjacent lines can be continuously scanned. In some embodiments, the beam may be raster scanned over the area to be treated. Alternatively, the lines can be interlaced. In another embodiment, portions within each scanned line may be examined out of order. Thus, each line can be scanned in a sequence of passes in which selected, non-adjacent portions are irradiated. For example, within each line, every nth part starting at the first part of the line to the end of the line, and then starting at the second part not investigated in the first operation, all parts are irradiated during the complete sequence. Until every nth part can be examined. In some embodiments, the beam may be scanned across the scanning field in a pattern comprising a plurality of adjacent rows, each row drawing a line of adjacent portions of the subject's skin to be irradiated by respective pulses of the laser. Includes. All of the rows may be scanned multiple (n) times and all of the rows may be scanned before any row is repeated. Within each scan of a given row, only every nth portion can be examined and every nth portion of adjacent rows is such that every nth portion of each row can be non-adjacent nth portions of adjacent rows. It can be offset. Each time the rows are scanned, different nth portions that have not been examined previously are examined. After n scans of rows, all of the portions are irradiated, thereby covering the entire scanning field. For example, each row can be scanned twice, and every second portion within each row can be laser irradiated, with every second portion of each row being every second in the adjacent row(s). It is offset relative to the parts, whereby it is not adjacent to it, whereby the scanning field can be scanned in a "checker board"-like pattern. The scanning pattern can be circular/annular, helical, quadrilateral, and can be made of concentric rings, or any other shape to optimize the treatment process.

It will be appreciated that the required scanning time for multiple small portions of the subject's skin will be incrementally longer than the scanning time for a single larger spot according to previous methods. However, the increased scanning time caused by the use of a small (millimeter-less) spot size according to the present invention can be improved by increasing the pulse repetition rate of the beam of laser light. Suitably, therefore, the pulsed beam may have a pulse repetition rate greater than about 30 Hz. In some embodiments, the pulsed beam may have a pulse repetition rate greater than about 100 Hz. In some embodiments, the pulse repetition rate can be up to 1 KHz or higher. For example, in some embodiments, a laser with a pulse repetition rate of 2000 Hz, 4000 Hz or even 6000 Hz may be used. Considering the inevitable inclusion of other steps when treating a subject that increases the total time required for treatment (e.g., placement of the laser by the operator), the pulse repetition rate in the range of about 200 to 500 Hz is in most cases. Was found to be sufficient to ensure no material loss of throughput compared to previous methods.

As described above, the present invention thus provides a scanning head for the area of the subject's skin to be treated to deliver a pulsed beam of laser light to the area to be treated according to one or more aspects of the present invention as described above. Understand to place it. The laser beam can be automatically scanned over the scanning field of adjustable size and/or shape, and the contour of the scanning field can be shown to the operator to ensure the correct position of the field on the subject's skin using the aiming beam. have. When shooting a laser, each part of the subject's skin within the field is irradiated with only one pulse of laser light. That is to say, for a square scanning field with a size of 5 mm and a spot size of 0.1 mm, it will be understood that approximately 3000 pulses will be required to scan the beam over the entire field. That is to say, for a larger spot size of 1 mm, only about 30 pulses will be required. In general, the number of pulses of the laser required to irradiate the entire scanning field can range from 1 to about 10,000, more typically from about 100 to about 1000. With a pulse repetition rate of 100 Hz to 1 KHz, the time required to scan the entire field may be from about 10 ms to about 100 s, more typically from about 100 ms to about 10 s. After the scanning field has been scanned, the scanning head is a different part of the subject's skin if required, i.e., if the area to be treated is larger than the field or if the area to be treated has the scanning head at one location and is contoured so that it cannot be treated as a whole. Can be relocated on top.

In some embodiments, the shape of the scanning field may be calculated automatically by obtaining the shape of the area to be treated using optical or other means. For example, the shape of the area to be treated can be determined by camera and/or machine vision. The optical trace can be used to display the calculated shape of the scanning field relative to the subject's skin to the operator for verification prior to operation of the laser. For example, the optical trace may represent the outline of the calculated scanning field. Alternatively, the calculated field shape and its position in the subject's skin can be displayed to the operator on an appropriate screen.

The scanning head may therefore comprise at least one camera to obtain images of the subject's skin to be processed to determine the area to be treated and the corresponding required scanning field size and shape. Images can be processed using a suitable image recognition system. The scanning head may further include one or more lamps to illuminate the subject's skin to ensure acquisition of usable quality images.

According to an eighth aspect of the invention, therefore, a method of dermatological treatment is provided, the method comprising using a camera to acquire one or more images of at least a portion of an area of the subject's skin to be treated; Processing the one or more images using image-recognition techniques to determine the shape and size of at least a portion of the area to be treated; Adjusting the shape and size of the scanning field for the pulse range according to the determined shape and size of at least a portion of the area to be treated; And then scanning the pulsed beam of laser light over the entire scanning field with at least a portion of the area to be treated.

The methods of the present invention therefore comprise a sequence of method steps, which can be performed under the control of any suitable computing system. Each of the method steps may represent an algorithm that the structure may contain and/or may be represented in a number of sub-steps.

According to a ninth aspect of the present invention there is therefore provided a laser treatment device for dermatological treatment, the device comprising: A work head comprising a camera and a beam scanner for scanning a therapeutic laser beam having a spot size of less than 2 mm across a scanning field of adjustable size and/or shape; An optical input for connecting the beam scanner to at least one pulse therapy laser; An adjustable positioning device for stably positioning the work head adjacent to the area of the skin of the subject to be treated and an automatic control system for controlling the operation of the laser treatment device; The automatic control system receives one or more images of the area to be treated from the camera, processes the received images to determine a shape of at least a portion of the area to be treated, and the scanning field according to the determined shape of at least a portion of the area to be treated. It adjusts the size and/or shape and is configured to scan the therapeutic laser beam across the scanning field.

Suitably, the automatic control system may comprise a computer and software that, when executed by the computer, causes the laser treatment device to operate as described herein. As computers and software are well known to those skilled in the art, it is not necessary to describe in detail here how the invention should be implemented using such equipment. In some embodiments, however, the automatic control system includes at least one physical processor and computer-executable instructions that, when executed by the physical processor, cause the physical processor to execute at least one method according to the present invention. It will be appreciated that it may include memory.

Suitably, image recognition of at least a portion of the area to be treated can be performed using standard methods known in the field of image analysis. Multi-spectral imaging can be used, for example, to provide additional information to find the correct target shape of the lesion to be treated. Additionally, machine-learning and/or artificial intelligence methods can be used to recognize the area to be treated.

As mentioned above, the word head will further include one or more lamps to illuminate the area to be treated to ensure that the images captured by the camera are of good enough quality to enable their processing and/or image recognition. I can. Suitably, for example, the work head may comprise one or more LEDs operable to emit light in the visible range, such as white light, to illuminate an area of the subject's skin to be treated. This light can aid in image recognition of at least a portion of the area to be treated.

The work head may further include an optical tracer for delineating the scanning field to an operator on the subject's skin. The automatic control system may also be configured to control the optical trace device to display, on the subject's skin, an outline of the scattering field, adjusted according to the determined shape and size of at least a portion of the area to be treated.

In some embodiments, the laser device may further comprise a display adapted to receive from the control system a display signal representing images of at least a portion of the area of the subject's skin to be treated and to display these images on the screen. . The automatic control system may also be configured to display on the screen an outline of the scanning field, adjusted according to the determined shape and/or size of at least a portion of the area to be treated, superimposed on images of the subject's skin.

Suitably, the automatic control system may be configured to wait for receipt of a safety control signal from an operator after the scanning field is displayed before operating the beam scanner. The safety control signal may include a suitable trigger device selectively operable by an operator; For example, it may be created by a foot pedal, switch, button, or the like. In some embodiments, the control system allows the operator to access the scanning field via a suitable input device, such as, for example, a keyboard, a touch-screen, selection buttons, a rotatable knob or dial, etc., or a combination of two or more thereof. It can be configured to allow adjustment of shape and/or size.

In some embodiments, the work head positions the laser beam scanner relative to the area to be treated to enable adjustment of the positioning device to accurately position the word head adjacent to the area of the subject's skin to be treated thereby. It may further comprise an aiming beam device for emitting a visible aiming beam toward the subject's skin for presentation to the subject's skin. Conveniently, the aiming beam can be generated by an optical trace device of the kind mentioned above, which is accordingly in the form of a scanning field calculated by the automatic control system, optionally adjusted by the operator, before firing the treatment laser. And/or to selectively generate an aiming beam to position the optical trace and the work head to verify size.

An additional problem is that, in general, the subject's skin is not flat. This implies that even if the area to be treated is less than the maximum available scanning field of the beam scanner, there will be limitations on the area of skin that can be scanned with the therapeutic laser beam. The angle of incidence of the laser beam into the target area may further limit the achievable area. In some embodiments, the topography of the area to be treated may be processed by adjusting the focal length of the beam scanner, but this may also have limitations on the achievable correction. As an example, consider a burgundy spot lesion or other area to be treated that extends around the subject's wrist; The scanner will be able to cover only part of the wrist per scan.

To address this problem, in some embodiments, the laser treatment apparatus of the present invention determines the topography of at least a portion of the area to be treated and determines the achievable scanning field due to height variations, angle of incidence and optionally other limitations. Can be adapted to yield. In some embodiments, the laser treatment apparatus of the present invention may therefore further include one or more topography measuring instruments for measuring a topography of at least a portion of the area to be treated. For example, a laser treatment apparatus may include a distance measurement device for measuring distances to various portions of an area to be treated. Suitably, the distance measuring device can be embedded in the work head. Suitable distance measurement devices are known and available to those skilled in the art, including, for example, 3D cameras, dedicated measurement systems and 3D scanners. In some embodiments, an aiming beam of the type described above may be used to perform triangulation to yield a topography. The automatic control system can also be configured to determine a topography of at least a portion of the area to be treated based on measurements of this kind. The control system may be configured to fuse the shape and size and topography of at least a portion of the area to be treated to yield the shape and/or size of the achievable scanning field.

In some embodiments, the contour limitation of the target lesion or other area to be treated may cause it to extend beyond the achievable scanning field of a single scan. In some embodiments, the lesion or other area to be treated may be too large for a single scan, even for a flat topography. In accordance with the present invention, the positioning device may allow the work head to be placed in a number of different positions to allow treatment of the entire area to be treated in multiple segments. Thus, the work head can be placed in a new location covering different portions of the subject's skin for complete coverage of the required area to be treated.

In some embodiments, the work head may be manually repositioned by an operator. At each location, the control system may be operable to process one or more images of an adjacent segment of an area of the subject's skin to be treated as described above to detect the boundaries of the segment. Suitably, the control system may use an image processing method that relies on images of untreated skin to identify a segment of the area to be treated. The required shape and size of the scanning field for treating the segment can then be determined as described above. The treatment laser can then be operated to irradiate the segment across the scanning field. Using an aiming beam of the kind described above, the operator can position the work head over each segment to be treated in turn so that it usually overlaps with one or more previously treated segments, including the immediately previously treated segment, if any. . The operator may use “frosting”, which occurs as a result of laser treatment of the skin, for example to identify previously treated segments. The automatic control system can be configured to mask portions of each segment that overlap previously identified segments at different locations of the workhead, so that portions of the skin in areas of overlap between two or more adjacent segments are treated as a single treatment. It is not investigated more than once within. Image stitching algorithms of the kind known to those skilled in the art can suitably be used to identify areas of overlap between the identified segments. At each location, the camera may have a larger field of view than the achievable scanning field to enable identification of segments of the area to be treated using untreated skin.

Alternatively, the positioning device can be automated and the automatic control system can also be configured to control the positioning device to position the work head. In this way, the work head can be automatically placed to scan successive scanning fields. Successive scanning fields can be adjacent to each other to ensure full coverage of the area to be treated. Alternatively, successive scanning fields can overlap and an image stitching algorithm of the kind described in the previous paragraph can be used to mask the areas of the overlap. An example of a suitable automated positioning device is a robotic arm with sufficient degrees of freedom to cover the entire area to be treated. The robotic arm will be able to monitor and record its position as described below.

Suitably, the automated positioning device may be switchable between a first mode in which the work head can be freely moved by an operator and a second mode in which the position of the work head can be adjusted only under the control of the control system. The positioning device may include, for example, at least one selectively operable clutch to allow the positioning device to selectively switch between these two modes. In the first mode, the positioning device can be moved by the operator without resistance, but if it is not released by the operator, it can hold the work head sufficiently stably so that it does not move under gravity, for example.

In a first mode, the work head can be manipulated by an operator to capture one or more images of the entire area to be treated. In the second mode, the work head can be automatically moved over the area to be treated under the control of an automatic control system to treat the subject's skin with pulsed laser light according to the invention.

In some embodiments, the automatic control system may be configured to operate a learning mode and a scanning mode. In the learning mode, the operator holds the work head with a positioning device (eg, a robot arm) in a first mode and manipulates it over the entire contour, all around the area to be treated. The work head can follow the operator's guidance without resistance in the first mode. The camera is continuously operated to capture images of the subject's skin while the robotic arm continuously measures its position on all axes and records its motion and path followed by the operator. At the end of this sequence, the automatic control system received a number of data-sets: captured images, positions and trajectories of the work head and 3D contour and distance measurements of the area to be treated. The automatic control system is then configured to calculate the scanning path by optimizing the scan path. As a first approximation, the path taken by the operator in the learning sequence can be used.

Alternatively, a standalone 3D scanner can be used to scan the subject, and the operator can enter the area to be scanned on the computer. Based on the above definition, the control system can then calculate the required 3D trajectory of the scanner head.

In the scanning mode, the positioning device is switched to the second mode, and the work head follows the path created by the control system while operating the beam scanner in continuous scanning fields to scan the pulsed laser beam over the entire area to be treated. It is moved under the control of the control system to follow.

In some embodiments, the laser treatment apparatus may further include an interlock device to be operated by a subject receiving the treatment. The automatic control system may be configured such that it can be operated only when the subject positively operates the interlock device. The interlock device may include any suitable buttons, triggers, switches, etc. that the subject may hold in their hand during treatment. Suitably, the interlock device is non-latching. If the subject releases the interlock device during operation of the laser treatment device, an interlock control signal is transmitted to the control system, causing the laser device to immediately pause its operation. Thereafter, when the subject reactivates the interlock device, the control system can be configured to wait for the operator to provide the necessary input signal again by operation of the above-mentioned trigger device. In this way, if the subject feels anxious about the movement of the robotic arm or any other positioning device during treatment, they can cause the device to stop. If the laser beam is mechanically scanned over the area to be treated by a robotic arm, x-y or x-y-z stage, etc., it will be understood that the movement is very fast and intimidating. However, when an optical scanner is used, the fast motion is only optical and the positioning device does not move or only moves very slowly.

Since treatment may take several minutes or more, it is inevitable for the subject to move to some extent. In some embodiments, therefore, the laser treatment device includes movement of the subject; In particular, it may further include one or more motion detectors for detecting the motion of the area to be treated. Motion detectors may include a camera on the word head or device to make 3D measurements of the subject's skin. The motion detector may be configured to detect the motion of the subject, and the control system automatically corrects the scanning of the therapeutic laser beam to compensate accordingly or, for example, the detected motion is too large for safe operation, or If it is too fast, it can be configured to stop scanning. Markers or indicators may be attached, pasted, or drawn on the subject's skin in some embodiments to enable measurement of the subject's motion.

The laser treatment device of the present invention is adapted for use with pulsed lasers. Suitably, therefore, the laser treatment device may further comprise a pulse treatment laser and an optical system for coupling the treatment laser to the optical input of the work head. In some embodiments, the laser may be a mode-locked laser capable of generating pulses of laser light with a pulse width of about picoseconds. As described above, in some embodiments, the pulses may have a pulse width in the range of about 0.1-100 ps and an intensity of ^{at least about 50 GW/cm 2.}

It is understood by those skilled in the art that the features of the present invention described above with respect to the first to eighth aspects of the present invention apply equally to the laser treatment apparatus of the present invention and do not need to be repeated here for brevity. Will make sense.

According to a tenth aspect of the present invention, therefore, a laser device for dermatological treatment is provided, wherein the laser device is a pulse treatment laser, a work for delivering a pulsed beam of laser light to an area of the skin of a subject to be treated. A head, and an optical system for coupling a treatment laser to the work-head; The arrangement allows the pulsed laser beam to have a pulse width in the range of about 0.1-100 ps and an intensity of ^{at least about 50 GW/cm 2.}

As explained above, the fluence of each pulse at the depth of the epidermis is about 0.5 to 10 J/cm ² ; Preferably, it may be in the range of about 1 to 8 Jcm ² or about 1 to 7 J/cm ^2.

In some embodiments, as described above, the beam scanner has each pulse in use less than about 0.1 to less than 2.0 mm; Preferably, it may be configured to be delivered to the skin of the subject in the form of a spot having a maximum dimension in the range of about 0.5 to 1.0 mm.

According to the eleventh aspect of the present invention, therefore, a laser treatment device for dermatological treatment is provided, wherein the laser treatment device is a pulse treatment laser, of a subject to be treated so that each pulse impinges on a different part of the subject's skin. A work-head comprising a beam scanner for scanning a pulsed beam of laser light into an area of the skin, and an optical system for coupling a therapeutic laser to the beam scanner; The arrangement allows each pulse during use to be less than about 0.1 to 2.0 mm by the beam scanner; Preferably, it is delivered to the skin of the subject in the form of a spot having a maximum dimension in the range of about 0.5 to 1.0 mm, so that the fluence of each pulse is in the range of ^{about 1 to 7 J/cm 2 at the depth of the epidermis.} do.

Suitably, as described above, the beam scanner may be configured such that different portions of the subject's skin are separated from each other by at least about 0.1 mm.

According to a twelfth aspect of the present invention, therefore, a laser device for dermatological treatment is provided, wherein the laser device is a pulse treatment laser, the skin of a subject to be treated so that each pulse strikes a different part of the skin of the subject. A work-head comprising a beam scanner for scanning a pulsed beam of laser light in an area of and an optical system for connecting the treatment laser to the beam scanner; In the above arrangement, each pulse during use ^{has a fluence at the depth of the epidermis in the range of about 1 to 7 J/cm 2} by the beam scanner and is delivered to the skin of the subject in the form of a spot, and different parts are at least about 0.1 mm. To be separated from each other.

In some embodiments, as described above, the spots may overlap each other. The beam of laser light can be attenuated so that its intensity is lower in the surrounding outer area than the rest of the beam.

In a thirteenth aspect of the present invention, therefore, a laser device for dermatological treatment is provided, wherein the laser device is a pulse treatment laser, the area of the skin of the subject to be treated so that each pulse impinges on a different part of the skin of the subject. A work-head comprising a beam scanner for scanning a pulsed beam of laser light with an optical system for coupling a therapeutic laser to the beam scanner; This arrangement allows each pulse during use to be delivered to the subject's skin in the form of spots with fluence at the depth of the epidermis in the range of ^{about 1 to 7 J/cm 2 by the beam scanner, and the beam has an intensity of} It is attenuated to be lower in the outer surrounding area than the rest of the beam.

Advantageously, the beam scanner can be configured such that, as described above, a beam of laser light is scanned across the scanning field in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated. .

In a fourteenth aspect of the present invention, a laser device for dermatological treatment is provided, wherein the laser device includes a pulse treatment laser and a beam scanner for scanning a pulsed beam of laser light into an area of the skin of a subject to be treated. A work-head and an optical system for coupling a treatment laser to the beam scanner; The arrangement allows each pulse during use to be delivered to the subject's skin in the form of spots with fluence at the epidermal depth in the range of ^{about 1 to 7 J/cm 2 by the beam scanning device.} The beam of laser light is configured to be scanned over the scanning field in a series of linear or curved lines such that the pulses hit different portions of the area to be treated.

As described above, the pulsed beam is greater than about 30 Hz, preferably greater than about 100 Hz; Optionally, it may have a pulse repetition rate of 200 to 500 Hz. In some embodiments, the pulsed beam may have a pulse repetition rate of up to about 1000 Hz. Suitable pulsed lasers capable of the above-described requirements are commercially available high pulse energy and high repetition rate picosecond lasers from Photonics Industries of Long Island, New York, under the designation RGL-1064-4 capable of delivering 4 mJ energy at 1000 Hz and at 1000 Hz. It includes a high energy KHz repetition rate picosecond amplifier available from Ekspla of Vilnius, Lithuania, under the name APL2201 capable of delivering 10 mJ.

Those skilled in the art will recognize that pulsed lasers of the kind mentioned above are very expensive pieces of equipment. It will also be appreciated that when treating a series of subjects, the laser has not been in use for a significant amount of time, which is typically about 50% of the time. As described above, in some embodiments, the present invention uses a fast pulse repetition rate to compensate for the smaller spot size compared to previous treatment methods. In addition, the color removal according to the present invention comprises a minimum amount of energy per pulse; Typically it requires 1 to 50 mJ as mentioned above.

In some embodiments, a single treatment laser may be arranged to selectively deliver pulsed laser light to a plurality of laser treatment devices in accordance with the present invention. Each laser treatment device may be provided in a different treatment area, such as a different treatment room, for example. As described above, each of the laser treatment devices may include a work head and an optical input for coupling the work head to the treatment laser. An optical system including an opto-machine selector can be provided for selectively coupling a therapeutic laser to one of the laser treatment devices. In this way, the therapeutic laser can be used to deliver pulsed laser light to one of the laser treatment devices to treat a subject while the other laser treatment device is not in use. This arrangement may allow for more utilization of therapeutic lasers.

According to a fifteenth aspect of the present invention, therefore, there is provided a dermatological laser treatment facility, the dermatology laser treatment facility comprising: a pulse treatment laser; A plurality of distinct treatment areas; A laser treatment device at each treatment area, each laser treatment device comprising a beam scanner for scanning a treatment laser beam with a spot size of less than 2 mm over an area of the skin of the subject to be treated and an optical The laser treatment device, including an input; And an optical system for coupling the treatment laser to the optical input of the work head of each laser treatment device; The optical system includes an opto-mechanical selector operable to selectively steer the laser beam to any of the laser treatment devices.

Suitably, the pulsed therapy laser may be operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz as described above.

Each pulse may have an energy of 1 to 50 mJ, preferably about 1 to 30 mJ. In some embodiments, the pulse therapy laser may have a pulse repetition rate of greater than 100 Hz, preferably at least 200 Hz and more preferably at least 500 Hz. In some embodiments, the pulsed therapy laser may have a pulse repetition rate of 1000 Hz or higher.

The laser light can be electronically modulated in the treatment laser according to the specific requirements of each treatment area.

In some embodiments, a high pulse energy therapeutic laser may be used. As described above, rather than toggling the beams sequentially between treatment areas, a passive optical splitter can be used to split the beam for use by a plurality of laser treatment devices of the present invention in parallel. In this way, the laser treatment device can be used at the same time in different treatment areas.

According to a sixteenth aspect of the present invention there is therefore provided a dermatological laser treatment facility, the dermatological laser treatment facility comprising: a pulse treatment laser operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz; A plurality of distinct treatment areas; A laser treatment device at each treatment area, each laser treatment device comprising a beam scanner for scanning a treatment laser beam with a spot size of less than 2 mm over an area of the skin of the subject to be treated and an optical The laser treatment device comprising an input; And an optical system for connecting the pulsed treatment laser to the optical input of the work head of each laser treatment device; The optical system includes a passive optical splitter for separating the beam and directing it to each of the laser treatment devices at the same time.

Suitably, the pulsed therapy laser may have a pulse energy of at least 5 mJ. In some embodiments, the pulsed therapy laser can have a pulse energy of up to about 300 mJ. For example, in some embodiments, a pulse energy of 10 mJ, 15 mJ, 20 mJ or 30 mJ may be used. The treatment laser can be operated continuously at full power output. At each workhead, the beam scanner is a high-speed optical modulator, e.g., a pockel cell, a galvo mirror, etc. to modulate the segmented laser beam according to the specific requirements of each separate treatment area. It may include.

Typically, the beam can be split between at least two laser treatment devices/treatment areas. Due to the properties of the therapeutic laser on pulse repetition rate and pulse energy, limitations on the number of times a beam can be split while maintaining sufficient pulse energy within each daughter beam for dermatological pigmentation removal as described in this application. There is this.

In another variant of the invention, therefore, a beam multiplexing technique can be used to split a single pulsed laser beam between multiple treatment areas. An optical system connected to a therapeutic laser with a high-speed pulse repetition rate is arranged in series and a plurality of optical modulators selectively operable to independently take selected pulses of the pulsed laser beam and direct them to each laser treatment device according to the present invention. Can include.

According to a seventeenth aspect of the present invention, therefore, a dermatological laser treatment facility is provided, the dermatological laser treatment facility comprising: a pulse treatment laser operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz; A plurality (n) of distinct treatment areas; A laser treatment device at each treatment area, each laser treatment device comprising a beam scanner for scanning a treatment laser beam with a spot size of less than 2 mm over an area of the skin of the subject to be treated and an optical The laser treatment device comprising an input; And an optical system for coupling the pulsed therapy laser to the optical input of each laser therapy device; The optical system is arranged in series and includes a plurality (n) equal to the number of treatment areas of optical modulators selectively operable to sequentially steer successive pulses with different ones of the laser treatment devices, each optical modulator being every n Take the second pulse.

Examples of optical modulators include Pockel cells, high speed galvo mirrors, rotating polygon scanners and others known to those skilled in the art.

In this way, a single pulse therapy laser with a high pulse repetition rate can be repeatedly directed to a plurality of different laser therapy devices by selectively directing continuous pulses to different ones of the laser therapy devices up to the number of continuous pulses equal to the maximum number of laser treatment devices It can be used to supply pulses of an undivided beam of laser light. Thus, each treatment device can selectively receive the pulsed laser light at a frequency equal to the original frequency of the pulsed treatment laser divided by the number of treatment devices. For example, if a laser is used to supply three treatment devices, the available pulse repetition rate for each treatment device is equal to 1/3 of the pulse frequency of the treatment laser. For this reason, it is desirable to use a therapeutic laser with a pulse repetition rate as fast as possible, preferably in excess of 100 Hz, preferably in excess of 200 Hz and more preferably in excess of 500 Hz. In some embodiments, a pulse repetition rate of 1000 Hz or higher may be used. In some embodiments, a pulse repetition rate of up to 2000 Hz, 4000 Hz or even 6000 Hz may be used to minimize the number of treatments to simultaneously treat multiple subjects using a single laser beam.

It will be appreciated that the pulses of the laser beam are directed only to a given laser treatment device when the associated optical modulator is driven. If the optical modulator is not driven, pulses of energy continue within the optical system until they are received in a suitable beam dump provided for this purpose.

Alternatively, pulses may continue to be directed to different treatment areas, but an additional optical coupler may be added in series at each area to modulate the pulses required for treatment at each area.

As explained above, each pulse should have an energy of about 1-100 mJ. Suitably, the pulses received at each laser treatment device are further modulated by each beam scanner for a pulse duration calculated to provide fluence at the depth of the skin in the range of about 0.5-10 J/cm2. Can be. Appropriate pulse durations, spot sizes and intensities are described above.

Laser treatment devices for use on human skin are reliable within the required operating parameters as described above, including, for example, the power and/or position of the laser beam incident on the area of the skin to be treated. You will understand the importance of ensuring that it will work and work consistently. To this end, the laser treatment apparatus of the present invention may comprise a test apparatus incorporating one or more sensors to test one or more physical and/or operational characteristics of the laser beam and/or work head.

Suitably, the test apparatus may include a support structure including a work head fastening portion configured to engage the work head and at least one sensor fixed to the support structure at a position spaced apart from the work head fastening portion. Suitably, the sensor(s) are fixed to the support structure so that when the work head is engaged with the work head fastening portion, the distance between the sensors and the work head is approximately equal to the distance between the work head and the skin when the laser treatment device is in use. Can be. In this way, the sensor(s) can be positioned in a plane optically corresponding to the plane of the skin when the laser treatment device is in use. As explained above, the work head can be adapted for connection to a removable spacer. The work head can therefore comprise a spacer fastening portion. The work head fastening portion of the support structure may be configured for releasable fastening with the spacer fastening portion of the work head.

Advantageously, the support structure may comprise a perforated separator plate interposed between the work head fastening portion and at least one sensor. The separator plate may be formed with one or more holes extending therethrough. The rest of the separator plate may be opaque to the laser light emitted by the work head. One or more holes may be formed in the separator plate at known positions relative to the work head fastening portion. Thus, the separator plate is properly fixed to the support structure in the correct position. The separator plate can therefore be used to detect the perturbation of the laser beam scanner at the work head. In the test mode, the beam scanner may be operated to steer the laser beam through one or more holes to ensure that the beam scanner does not stray and the beam scanner operates as expected. One or more optical sensors are provided on the support structure on the opposite side of the separator plate from the work head fastening portion to detect light passing through the one or more holes accurately.

In some embodiments, a position sensitive detector of the kind available to those skilled in the art capable of measuring the position and power of a laser beam may be used in place of or in addition to a perforated separator plate. In some embodiments, the separator plate may be formed with a plurality of holes of different sizes to allow for divergence of the beam. The one or more sensors may include a corresponding number of power sensors to measure the power of the laser beam emitted by the work head, each power sensor associated with a respective one of the holes. It will be appreciated that holes of different sizes will cause different power levels to be measured by the respective power sensors.

Suitably, the support structure may support one or more lenses between the one or more sensors and the work head fastening portion to adapt the optical path of the laser beam to the test apparatus. At least one lens may be positioned between the separator plate and the work head fastening portion.

Conveniently, the support structure of the test device may include a holder for detachably holding the work head when it is not in use.

What follows is a description with reference to the accompanying drawings of embodiments of the present invention by way of example only.

In the drawings:
1 is a schematic side view of a dermatological laser treatment facility including a laser treatment device according to a first embodiment of the present invention.
FIG. 2 is a schematic cross-sectional view of an optical path and a scanner head of the dermatological treatment apparatus of FIG. 1 shown connected to a pulsed laser through an articulated arm for delivery of a laser beam to a subject. The work head includes a galvanometric xy scanner as a beam steering device. The beam is then focused to reach the desired size on the subject's skin.
3 is a side view of a manually movable scanner work head forming part of the dermatological laser treatment apparatus of FIG. 1.
4 is a rear view of the work head of FIG. 3.
5 shows various scanning fields of different sizes and shapes selectable in the work head of the system in FIG. 1.
6 is a flowchart of the operation of the dermatological laser treatment apparatus of FIG. 1.
7 is a flow chart of a method for removing tattoos or other pigmentation from the skin of a subject according to the present invention.
8A illustrates treatment of an area to be treated according to a conventional method. 8B illustrates optimization of the shape/size of a scanning field according to the present invention. In the conventional method as shown in Fig. 8A, the thin stem of a typical rose-shaped tattoo requires a very small spot size; Multiple spots with correct placement are required to cover the entire stem. Conversely, in the scanning method of the present invention, the scanning field can be programmed into any desired shape. For example, an elongated rectangular scanning field can be more efficient and faster to treat long, thin tattoo lines.
9 is a flow diagram of a method for determining the required working fluence (intensity) for pigmentation removal using pulsed laser light of different pulse widths.
10 is a chart of measured laser ablation critical fluence versus pulse width for various colors of the pigment. It is clear that shorter pulse widths require less fluence, and the threshold difference between different colors is smaller.
11 shows an example of a multicolor tattoo removal according to the invention using a high intensity laser compared to a conventional method using a low intensity laser. Pictures showing actual removal results from controlled experiments performed on live pig skin are depicted.
12A and 12B show skin temperature profiles over time. 12A shows the temperature profile resulting from the high energy large spot. 12B shows the temperature profile resulting from the low energy small spot. The onset of heat diffusion is evident at time scales of about 10 s for a large spot. For small spots, the diffusion of heat is evident after less than about 0.1 s.
13 is a chart showing the temperature at the center of the volume of heated tissue as a function of time. The thermal relaxation time (50% of the initial temperature delta) for a 1 mJ, 0.22 mm spot is about 0.12 s; For a 5mJ, 0.5mm spot, the heat relaxation time is about 0.7s; The heat relaxation time for a 500mJ, 5mm spot is about 70s.
14 is a chart plotting thermal relaxation time versus pulse energy for a given fluence of 2.5 J/cm2.
15A and 15B schematically illustrate raster scanning versus interlacing of the area of the skin to be treated according to the present invention. 15A shows standard raster scanning with a time T between adjacent lines. 15B shows the interlacing scan by skipping the K lines and going back to the top after the bottom line. The time between rows is T*K.
16 is a cross-sectional side view of a holder for a scanning head according to a second embodiment of the present invention.
FIG. 17 is an enlarged view of a separator assembly forming part of the holder of FIG. 16 and capable of testing the scanner, laser and optical tuning prior to treatment.
18 is a flow chart illustrating the operation of a holder to perform a test routine.
19 is an illustration of an automated scanning workhead connected to a balanced articulating arm disposed on a treatment chair according to a third embodiment of the present invention.
20A is a schematic illustration of a bottom surface of the scanning workhead of FIG. 19.
FIG. 20B is a side view of the scanning workhead of FIGS. 19 and 20A, including a schematic illustration of the subject having the pigment to be removed.
21A-21E illustrate an example of an image acquisition, verification and tattoo-removal treatment sequence according to the present invention. In Fig. 21A, the aiming beam represents the scanning field outline to the operator. In Fig. 21B, the contour of the target area to be treated is measured and scanning parameters are calculated. 21C illustrates a preview of a scanning field/sequence using an aiming beam or an on-screen display. 21D and 21E illustrate a tattoo-removal sequence.
22A and 22B illustrate the effect of topography on the achievable scanning field. A planar target is shown in FIG. 22A and the entire scanning field of the scanner head can be used. In Fig. 22B, the non-planar target reduces the accessible scanning field. A spherical topology is shown for simplicity.
23 schematically illustrates the treatment of a pigmented area to be treated that is larger than the achievable scanning field. A stitching algorithm is used to treat the entire area in a plurality of scanning segments using pattern recognition of overlapping untreated areas.
24 is a perspective view of a 6-axis robot mounted with a scanner head.
25 is a schematic diagram of a dermatological treatment installation according to a fourth embodiment of the present invention in which a single pulsed laser beam from a single treatment laser can be selectively toggled between a plurality (in this case 2) different treatment areas.
26 is a schematic diagram of a dermatological treatment facility according to a fifth aspect of the present invention in which a single high-energy pulsed treatment laser beam is divided into a plurality of different treatment areas and steered simultaneously.
Fig. 27 is a schematic diagram of a dermatological treatment facility according to a sixth embodiment of the present invention in which a single high frequency (pulse repetition rate) pulse treatment laser beam is multiplexed into a plurality of separate rooms simultaneously by pulse-peaking.
28 is a timing diagram for pulse-picking used in the dermatological treatment facility of FIG. 27;
29 is a schematic diagram of electrical and electronic components and connectivity of the dermatological laser treatment apparatus according to an embodiment of the present invention shown in FIG. 1.

Example 1

1 of the accompanying drawings schematically shows a dermatological treatment facility according to an embodiment of the present invention. The equipment is provided in two adjacent rooms 12 and 13 separated by a dividing wall 21. One of the rooms 12 is a treatment room; Another is a laser chamber 13 housing the first and second treatment lasers 1 and 2. In this embodiment, the first laser 1 is an 800 nm Ti:sapphire laser generating ultra-short pulses, and the second laser 2 is a 1064 and 532 nm Nd:YAG laser. The Ti sapphire laser has 1 to 10 millijoule energies at 1 Khz pulse repetition rate and emits 100 to 30,000 femtosecond pulses. The Nd-Yag laser emits sub-nanosecond pulses at similar energies and 500 Hz pulse repetition rates. It will be appreciated that different lasers may be used in other embodiments of the present invention. The aiming beam 5 is the treatment lasers 1 as described below in order to assist in positioning the work head 4 as described in more detail below at a precise location above the area of the skin of the subject to be treated. , Optically coupled to 2). A power and control unit 6 is provided, which includes a computer, a power supply and dedicated controllers for system operation.

The laser chamber 13 ensures that optimum conditions for the lasers 1 and 2 are maintained. The treatment room 12 contains only operator and subject-accessible equipment.

Each of the first and second treatment lasers 1, 2 transmits the laser beams 11 generated by the lasers 1, 2 through the dividing wall 21 and they form the dermatological treatment apparatus according to the present invention. It has a laser output 23 that is connected to an optical system 22 for directing to a treatment room 12 that is fed to the containing work station 25. The optical system 22 may be any suitable arrangement of mirror lenses and other optical components known to those skilled in the art (described below) and it is housed in a protective conduit through the dividing wall 21. .

In the treatment room 12, adjacent to the work station 25, a treatment chair 10 is provided for a subject (not shown) to be treated.

The work station 25 includes a console 7 and an articulating arm 3 that is fixed to the wall or floor of the treatment room 12 for stability. The articulating arm 3 carries the aforementioned work head 4 at its free end. Articulated arm 3 can selectively direct therapeutic laser beams and aiming beams to optical inputs on work head 4 at any point in the treatment room of a specific volume (by using mirrors and abutment assembly). .

The work station 25 is connected to the foot pedal 8 to control the laser power.

Referring to FIG. 2, the treatment laser 31 (previously referred to as lasers 1 and 2 in FIG. 1) is controlled by a dedicated controller 44. For clarity, only one treatment laser 1 is depicted, but the arrangement of the second laser 2 is similar. Each treatment laser output 31 is driven by a high-speed detector 32 operable to sample a small percentage of the beam 42 using a beam sampler 35 (also acting as a collimating beam coupler in this embodiment). It is monitored in real time. The controller 44 is configured to stop the laser power and automatically close the shutter 33 when the output of the treatment laser deviates from the maximum or minimum pulse energy.

The aiming beam 34 is coupled to the therapeutic laser beam optical path by means of a coupling mirror 35. The beam path then travels through the beam expander 36 for propagation through the rest of the system. When moving through the articulated arm 43, all of the beams arrive at the work head 37.

The work head 37 includes a removable spacer 38 and a galvanometric scanner 41. In use, the laser beam travels to a galvanometric scanner 41 that is directed to the subject's skin by motorized mirrors 40 to pass through the lenses 39. The spacer 38 extends away from the work head and terminates at the smooth distal end to contact the subject's skin. The scanner galvanometric mirrors 40 are rotated so that the beam arrives at the focus lens assembly 39 at an angle. This angle is converted to a position on the subject's skin through the focus lens assembly. The lenses create the desired spot size on the surface of the skin, which can be resized by the operator to achieve the required fluence. In this example, a spot size of 0.7 mm is used for a 4 J/cm2 fluence, but it is by those skilled in the art that any spot size of less than about 2 mm, preferably less than about 1 mm can be used. As will be appreciated, the fluence is in the range of about 0.5 to 50 J/cm2, preferably about 1 to 30 J/cm2. The scanner 41 then steers the spot across the skin within a scanning field of adjustable size and shape. The distance between adjacent spots is configurable and is typically less than about 0.1 mm. In some alternative embodiments, overlapping spots with a Gaussian profile may be used. The amount of overlap can typically be about 0.1 mm. Different selectable rectangular scanning fields are shown in FIG. 5 by way of example. In particular, in this embodiment, the galvanometric scanner 41 is operable to scan a configurable rectangle of about 1 mm to about 10 mm in length and/or width. It will be appreciated that in other embodiments, the scanning field may have any predetermined or arbitrary shape within the limits of the scanner 41. The distance to the area of the subject's skin may be determined by the spacer 38.

The work head also includes a motion sensor 26. During operation of the main laser, if the motion sensor detects motion above a predefined threshold, it signals the control unit 6 to stop the main laser immediately. This helps to prevent unintended or uncontrolled lasing.

The work head 37 includes a scanning field size selector knob 14, a contour switch 15 for activating the aiming beam 34, an indicator light 19 and a replaceable spacer 18 (38 in Fig. 2). It includes an outer shell 20 as best shown in FIGS. 3 and 4 which is designed as an ergonomic, plastic assembly.

The scanner mirrors have various aspect ratios and can be programmed to scan one of a set of predefined rectangles (FIGS. 5, 45-54) in sizes ranging from 1 to 10 mm. Each rectangle corresponds to a specific setting of the field selector knob 14. In other embodiments of the present invention, the scanner mirrors may be operable to create scanning fields of different sizes and/or shapes other than rectangles, such as circular scanning fields.

As best seen in FIG. 29, the controller unit 6 includes a power supply 401 with power lines 401, a processor 402 with a memory for storing software and data 404, and A real-time controller 405, and a programmable logic device 403. In combination, they have acceptable redundancy and ensure smooth and safe operation of the system. Signals and data are connected to various system components (1, 2, 5, 4, 37, etc.) as shown via power and data lines 411. The real-time controller 405 and processor 402 communicate with the digital scanner controller 406 and consequently operate a similar scanner driver 407. These supply both power and control from the work head 37 to the galvo mirror scanner 41. For clarity, many connections and details have been omitted.

The system follows the logic depicted in the diagram of FIG. 6. During power up 61, prior to the idle state 62, several safety checks are performed. Once the contour switch 15 is switched on by the operator, the system moves to contour mode 63. The system remains in contour mode, continuing the rectangular contour (i.e. one of 45 to 54) with the aiming beam 34 until the contour switch 15 is turned off or the foot pedal 8 is depressed. And scan. When the foot pedal is pressed, the main laser is turned on and pulses of laser light are scanned over a rectangular scanning area in the full scan mode 64. Once the entire area has been irradiated by laser pulses, the laser is switched off and the system returns to contour mode 63.

During application of the treatment, the operator examines the shape and size of the pigment to be removed (70). Once the operator turns on the contour scan, the aiming beam then shows the currently selected rectangular contour on the subject's skin as shown in FIG. 7 (73). This allows for visual feedback and accurate tuning of the scanner to the treated area. The operator adjusts the field selector so that the rectangle fits the pigment shape and size and accurately positions the work head over the pigment area (77). Once the operator is satisfied with the set scanning field arrangement, the foot pedal 8 is pressed, and the main laser then covers the entire area of the scanning field with laser spots-one spot at each location. The skin of the woman is examined (79). In this embodiment, the total scan duration is less than 1 second, typically 0.5 seconds. After a full scan, the main treatment laser is switched off and the aiming beam 34 again outlines the treated area (81). The treated areas are usually visible due to the frosting effect of the pulsed laser and skin interactions (82). To achieve optimal results, the laser set point is selected as described in Example 2 below.

The throughput benefit of adapting the scanning field shape to different areas of the tattoo or pigment can be understood by comparing the examples shown in Figs. 8A and 8B. Using the appropriate rectangles 86 to cover an elongated shape such as a stem of a rose, for example, requires 5 scans. For a square or circular shape 85, the number of scans is about three times or more. Since the single field scan is very fast, the operator's placement process is the main contributing factor to the total treatment time. Thus, fields less than 3 times convert to ˜3 times faster treatment time. For example, for a 3 mm thick and 50 mm long stem, using a 500 Hz pulse repetition rate and a 0.6 mm spot size with no overlap, we reach approximately 830 spots, which equates to a net scanning time of 1.7 seconds. Using a 3x3mm field (see Fig. 8A), there are approximately 17 distinct fields to scan. Assuming a well-trained operator with a field placement time of about 0.75 seconds, we have a placement time of 12.75 seconds and a total treatment time of 14.45 seconds. When using a rectangular field of 3 x 10 mm as shown in Fig. 8b, we have -5 batches, so the total treatment time is 5.45 seconds. The difference between 15 and 5 seconds is not prohibitively high during the treatment session, but by repeating this analysis for much more pigmented areas with complex shapes and features, by optimizing the field shape, there is a huge reduction in treatment time. It is clear that it can be achieved. Example 5 below takes this concept further to achieve even shorter treatment times.

Example 2

The use of ultra-short and ultra-high intensity radiation according to the invention is advantageous for removing several colors with one wavelength, beyond very color selective linear absorption. When designing a new system, it must determine an appropriate laser working point to achieve multi-color pigmentation removal. Working points include fluence, pulse width and intensity. The intensity is required to be high enough for multi-color removal, which is usually determined by the combination of fluence (energy density) and pulse width. The fluence should be high enough to support strength, but not too high to create excessive damage (typically about 0.5-10 J/cm ² ). The pulse width should be short, but is usually limited by the specific laser design. Preferred pulse widths are approximately 0.5 to 30 picoseconds. Pulse energy is discussed in Example 3 below. The optimal working point depends on the wavelength of the particular laser, the target colors (usually more is better) and the available laser pulse width of the particular laser system. To find a suitable working point, we measure the response thresholds of different ink colors/skin pigments in the laboratory setup. The test is repeated for each target pigment. The test target is created by mixing gelatin, water and pigment. Referring to Fig. 9, the target is then scanned with a set of fluences, where for each fluence, the pulse width is modulated (virtually the modulation intensity). Once an interaction is observed at the target (usually depending on the damage at the target), a threshold fluence for a particular pulse width is determined. By finding the highest intensity required for the most difficult damaged color, we reach the required intensity covering all colors. In this method, it should be noted that the intensity and fluence are tested independently via pulse width modulation and are essentially different from prior art methods, where the fluence and intensity are combined since the pulse width is constant.

10 shows the results of actual laboratory measurements. As the pulse width increases, more and more fluence is required for effective interaction with the target pigment. The spread of different fluences required for different colors also increases significantly. Prior art laser systems typically operate with >250ps pulse width and lower intensities. That is to say, for a given fluence at the pigment site in tissue of ~1 J/cm2 (indicated by reference numeral 100 in FIG. 10), the system can remove green and black, for example, but red and yellow colors. I won't be able to. This is because yellow and red have significantly higher fluence thresholds for the pulse width. Alternatively it can state that "they do not absorb enough" at a given wavelength and pulse width. By reducing the pulse width below -25 ps according to the invention, the same fluence 101 can successfully remove all colors in this case. This is because, at this pulse width, the threshold for interaction is less than a given fluence. It should be noted that the same wavelength as in the prior art can now remove all colors as a result of greater intensity.

The method is applicable for a specific laser wavelength, where different lasers require different maximum intensities and/or fluences depending on the target colors versus the wavelength used. However, once the critical intensity is used, all target colors will be removed by the particular laser.

It is intended here that by "removal" a complete clearance (visually) of the color from the skin is achieved after a limited number of sessions. The number of sessions may vary from one target color to the next, but anyway the number of sessions from one color to the next will not vary by more than about a multiple of two.

Commercial lasers are available for a defined set of parameters. See, for example, PicoLaser ltd "Pico-1M" laser with 8mJ and 8ps pulse width, or Amplitude Laser ltd "Magma" laser with 30mJ and 1.5ps pulse width.

11 depicts the actual removal results in a controlled experiment performed on live pig skin, as an example of the method and system described above. The target was multi-colored, including areas colored in green (111), blue (112), cyan (113), orange (114), red (118), yellow (117), purple (116) and black (115). It is a colored square. There is no tattoo in the middle of the target, but the borders are outlined in black.

Pre- and post-images are shown 101-106, using various pulse widths and different treatments in the range of two months. Laser A has a pulse width of 6 ns; Laser B used 0.6 ns; Laser C used 1 to 15 picosecond pulse widths (100 to 1000 times shorter). Laser A and laser B used 4 J/cm2 fluence, whereas laser C used 2 J/cm2 fluence. The intensity of each of the lasers A/B was 0.7/7 GW/cm2, while laser C has an intensity in excess of 50 GW/cm2. With laser A and laser B, pronounced removal is achieved in the black contour (101 vs. 102 and 103 vs. 104). For short pulsed laser C, all tattoo colors responded and a clearance of over 80% was achieved (105 vs. 106). Quantitative clearance levels are shown at 107.

Example 3

The process of laser pigmentation removal, even if targeting the pigment, produces localized heating in the tissue surrounding the pigment. Local damage in the pigmented tissue is inevitable, but the surrounding tissue, which is not directly damaged by pigment radiation absorption, will suffer from secondary heating. The duration of the local elevated heating is the root cause of higher damage to the surrounding tissue. In the following example, we will quantify these effects.

During irradiation of the pigmented tissue, the following occurs: Initially, on the time scale of the laser pulse width, in the parts of the tissue that the radiation absorbs, it is usually absorbed in specific chromophores targeted for treatment. They can achieve very elevated temperatures (even thousands of degrees) on very short time scales of pico or nanosecond. This usually leads to plasma generation, mechanical failure and/or other terrible events, which are usually the desired outcome of the treatment. Nevertheless, after a short time all this energy is finally converted into heat: the plasma radiation is reabsorbed after the end of the pulse, and the moving particles are slowed down through collisions to the stop. Except for chemical alterations (usually undesirable effects), eventually all incoming radiation is converted into heat.

For time scales much longer than the pulse width, we can use the bulk heat approximation for the absorbent layer to estimate the temperatures induced in the tissue. For example, consider an average 2.5 J/cm2 fluence, 500 mJ pulse energy, and 5 mm spot diameter. For example, tattoo inks that absorb laser radiation are usually/mostly at a depth of 300 to 700 μm below the skin surface. We assume that the diameter of the input pulse is absorbed into the thickness within a cylinder (for simplicity) and use the specific heat of water as a good estimate. Using ΔT = E/M·C, we reach a temperature rise of approximately 15° C. above the ambient skin temperature of -34° C. (outside) to 36.8° C. (inside).

This is also true for 5 mJ pulse energy (100 times lower energy and 10 times smaller diameter) with 0.5 mm diameter. The same average heating will always occur in this approximation if the fluence is similar.

The advantage of applying only small, low energy pulses is evident by looking at the heat diffusion over time. After a very fast initial heating process (less than about nanoseconds), the heat begins to diffuse away from the initially heated volume. Given that the subject's body is an infinite heat reservoir compared to the total pulse energy at high pulse energies, diffusion will gradually reduce the temperature of the heated volume back to its natural body temperature. The rate of this cooling effect is highly dependent on the volume of the heated tissue, which is very different in the examples above. More precisely, the rate is determined by the ratio of the surface area to the volume of the heated tissue. Smaller volumes will calm down much faster than larger ones.

To quantify the relevant time scales, consider the case of two pulses with the same fluence as in Example 2 above. Assuming only one pulse hits the tissue, at what rate will the heat spread? Let us solve that linear heat diffusion gives a radiation profile of temperature at different times after initial heating at time t=0. The temperature profiles of the high energy, large spot (FIG. 12A) and low energy, small spot (FIG. 12B) are shown in FIG. 12. After about 1 second, there is only a small change in the rising temperature for the 500mJ pulse 121, but the 5mJ pulse temperature has dropped by approximately 50% (122). For a 500mJ pulse, it takes about 100 seconds for the temperature to drop by 50%.

The thermal relaxation time can be defined here as the time at which the temperature delta has fallen by a factor of two. The temperature of the center of the heated tissue volume as a function of time is plotted in FIG. 13. For a 1 mJ pulse with a 0.22 mm spot, the thermal relaxation time is about 0.12 s. For a 5mJ, 0.5mm spot, the relaxation time is about 0.7s, but for a 500mJ, 5mm spot, the relaxation time is about 70s.

14 is a chart plotting thermal relaxation time versus pulse energy for a given fluence of 2.5 J/cm2. Box 142 shows a working point according to a conventional method using 200-1000 mJ pulses. Relaxation times of 30 to 200 seconds are typical. In box 141, much shorter relaxation times of 0.1 to 8 seconds are provided in accordance with the present invention using smaller pulse energies of 1 to 30 mJ. Skin damage thresholds are plotted at 143 and 144.

Considering that the skin can withstand only about 6 s at 51° C., as previously discussed (144) before damage occurs, so in the example above, using a 5 mJ pulse, it diverges in less than 1 second, It is clear that the skin can sustain a 15°C temperature rise up to about 51°C. For a 500mJ pulse, damage will occur since it has the same temperature rise and the relaxation time is about 70 s much longer than the damage threshold. The same analysis is true for a skin temperature of 50 degrees, which can be tolerated for 24 seconds before damage occurs. It is also known that pain appears before the injury occurs. The pain threshold is lower than the injury threshold, but the temperature dependence is similar (Yarmolenko).

For this reason, both pain and injury are reduced or completely avoided by using small energy pulses (1-30 mJ) instead of large pulses in excess of 200 mJ.

This calculation reflects a comparison of high energy pulses versus low energy pulses at the same fluence. In order to benefit from fast relaxation times when scanning large areas with multiple spots, it is important to provide adequate time between adjacent pulses. This can be achieved by using dedicated scanning techniques. 15B as an example of a smart scanning technique to increase the available relaxation time for adjacent spots. In a typical raster scan of N lines (FIG. 15A), each thick line 150 is made up of multiple spots. The time it takes to complete the line is T. This means that after time T, each spot will have a new neighbor below it and this is added to the left and right neighbors in its own line. Now we use an interlacing scan (Fig. 15b): instead of scanning the lines in succession, we scan the top line 151 and then much further away to mark the next line 152 below M The lines are skipped. We continue this until we reach the edge of the scanning field, return to the second line from the top 154 and repeat the process. This gives adjacent lines a relaxation time of K*T, K=floor(N/M), which can potentially be much longer for larger fields.

Example 4

To ensure proper functioning of the system and safety of subjects and operators, the system in Example 1 may be adapted to include specialized test hardware and sequences in a dedicated work head holder that may be located in the treatment room 12. The holder 27 of the present invention includes a work head interface 164, optical lenses 167, a perforated separator 169, and an optical power meter 161.

Referring to FIG. 16, the work head 4 is connected to the right side of the holder 164 as shown in the drawing. It should be noted that the connection is mechanically identical to the connection of the spacers 18 as described above with reference to FIG. 3 used for treatment.

To the left of 164 is a lens 166 to adapt the optical distance to the power meter 161. Above the power meter, there is a separator 169, and several holes were drilled to allow the laser radiation to reach the power meter.

17A shows the arrangement of the separator on the left side 170 in the direction of the detector and also the several holes 172 extending through the separator. 17B shows the right side of the separator 171 in the direction of the work piece.

The test sequence is shown in FIG. 18. The sequence starts only when the appropriate controls are applied, mainly when the aiming beam switch 15 is on and the foot pedal 8 is depressed. The scanner mirrors 40 are then moved in separator 172 to positions corresponding to the hole positions. In each position, the main laser 1/2 is turned on, and the power is measured in the power meter 161.

Once all the defined positions and power measurements are performed, the measured power is compared to a predefined table with acceptable ranges. The test is successful if all measurements are in predefined ranges.

Several advantageous aspects should be noted. The first aspect is that the power meter 161 (or any other related sensor) is positioned in a plane optically corresponding to the plane of the skin treated using the spacer 18. This is in contrast to conventional systems where laser radiation is usually measured closer to the laser power and not at the power of the system. This ensures that the subject receives the correct radiation parameters and takes into account failures occurring somewhere along the optical path: from inside the laser, through the optical elements in the workhead, through the scanner and lenses (see Fig. 2).

Second, different separator holes at different positions require the scanner mirrors 40 to reach predefined positions. This ensures that the scanner mirrors, their actuators and their control electronics all perform as expected. It also ensures that the optical beam does not move out of tune in angle or position, which will correspond to partially or completely missing separator holes (like mirror actuator failure) and causing low power measurements.

Also, by creating holes of different diameters, the divergence of the beam can also be taken into account. This divergence will result in different power levels measured compared to the predefined ones in holes of different diameter.

Also, during the test, real-time sensors located after the laser output 32 (see Fig. 2) are compared to the holder sensor to ensure that they consistently measure the pulse energy.

Finally, the sequence requires operation of the user controls in the same manner as normal operation during treatment, and takes into account any failures in the switches or controls.

It will be appreciated that the test device does not necessarily incorporate a holder for the work head. In other embodiments, the sensors are not designed to hold the workhead as such, and will be mounted on a support structure having a workhead fastening portion that is configured to engage the workhead to position it stably with respect to the sensors for testing. I can. Instead of a perforated separator as described above, the sensors may include at least one position sensitive detector to detect the position and power of the laser beam.

Example 5

19 illustrates a treatment room of a dermatological treatment facility including a laser treatment device adapted for automatic scanning of an area of the skin of a subject to be treated according to another aspect of the present invention. Over the treatment chair 190, a large optical work head 191 is hung through a balanced articulating arm 192. The device in a laser room (not shown) is similar to the device described in Example 1 above, but in this example the treatment room workhead is larger and uses imaging and other sensors to automatically scan a large area to be treated (example Compared to manually scanning small areas in 1).

Laser scanning is widely known from industrial material processing applications. In the present invention, in contrast to the industrial application of laser scanning, in which the same target material and sample are repeatedly scanned in large amounts, however, the subject is only scanned once (at least per treatment), and the required scanning pattern is not The two subjects are very rarely similar, as no two lesions are identical. Additionally, the cost of the error is unacceptable and safety considerations are of paramount importance. The following description shows how these problems can be addressed in accordance with the present invention to provide a fast, accurate and safe scanning of a laser to treat dermatological markings.

20A and 20B, the components of the working head 191 are shown in two cross-sectional views. Laser radiation enters the workhead input 200 from one or more treatment lasers in the laser chamber through the articulated arm 192 and passes through the motorized adjustable focusing lenses 208. It then enters the scanner 201. Such a scanner is larger than the scanner in Example 1 and is a 160mm f-theta lens to cover an area of 100×100mm on the skin 204 of the subject, which is usually maintained at a constant distance of about [DISTANCE] from the work head 191. Direct the laser beam through 202. Scanners, integrated focusing and f-theta lenses are readily available, for example, from ScanLab Germany, Massachusetts or Cambridge technology, USA. The camera 207 mounted on the workhead is operable to image the treatment area, but the illumination LEDs 206 supply specific lighting conditions. The camera 207 is also capable of 3D measurement of depth and can generate a height map of the area in addition to imaging the area to be treated. 3D cameras are readily available, for example, with RealSense from Intel, USA.

The treatment sequence is described in Figures 21A-21E. Initially, the operator manually manipulates the work head 191 so that it is approximately positioned above the target area. The articulated arms have little friction and are balanced to allow the operator to easily manipulate the work head. The aiming beam shows the available scanning field by showing its outline to help the operator place it in the center of the available scanning field to approximately match the target area (see Fig. 21A). Using image processing, the system then detects the pigment areas based on the images of the area captured by the camera 207. The 3D camera also measures the contours of the target area and scanning parameters are calculated (FIG. 21B). Once the scanning plan is defined, the operator sees the planned area to be treated. This can be done with a dedicated computer interface, but in this example it is shown directly on the subject target area; Using only the aiming beam, the correct planned pattern is repeatedly scanned as would be done by the main treatment laser (FIG. 21C ). The operator then approves the scanning plan by pressing a button on the user interface screen, after which the work head scans the approved area with the treatment laser (Fig. 21D). Following this scan, the system returns to outline the available field while the area treated as a result of frosting is typically white, as described above (FIG. 21E ).

It should be noted that all of the pigmented skin within the scanning field is treated immediately, without further operator intervention. This ensures the accuracy of the laser treatment while achieving very fast treatment times (up to 40 seconds, typically much less for a 100×100mm tattoo) compared to manual placement.

The system may use pre-measured and real-time depth data to adjust the focusing lens 208 to account for the scanner-skin distance and contours of the skin surface. In some instances, the contours of the target area may be curved such that it is not possible to scan the entire area: eg, a bracelet tattoo around the finger print. During the depth measurement (FIG. 21B ), the pigment area that is too curved to be treated (due to an angle above 20 degrees or due to the focal range of the system, typically a depth above 35 mm) is omitted from the planned scan. 22A and 22B illustrate an example of this feature: in FIG. 22A a planar target is scanned, and the full available scanning field 221 may be used. In FIG. 22B, the curved surface under the scanner 220 implies that a smaller area of the surface 223 can be scanned compared to a larger area of the flat surface 221.

The image processing algorithm for detecting the pigmented areas to be treated can be segmented between tattoos, using a first-order derivative for edge detection, but pigmented lesions with softer edges use a trained neural network algorithm. I can. These algorithms are easily understood by those skilled in the art. Since the accuracy of either algorithm is not 100%, the operator can use a suitable computer interface (not shown) to correct the algorithm results and manually adjust the scanning pattern if required. The pattern is then updated with pre-scan (Fig. 21C).

When treating an area larger than the maximum scanning field or a curved area that cannot be treated in one scan, the treatment can be divided into several segments. The operator manually places the scanner over each segment and starts the pattern recognition algorithm. Based on the previous images compared to the current image, an appropriate stitching algorithm identifies the treated previous segments and thus avoids treating the areas twice or missing some areas. This algorithm is shown in Figs. 23A-23E. In a first step (Fig. 23A), the scanner is placed over the top-left area of the area to be treated. Camera 207 captures an area 230, which is larger than the scanner maximum field 231. The pattern recognition algorithm identifies the pigment area and treatment is then performed on this area 235. The scanner is then moved to the right as shown in the figures by the operator (Fig. 23B). The operator needs to verify that there is some overlap with the old camera image 230 in the new camera image 236. This overlap is explicitly shown at 234 and 232 (the previous and current image overlap area). Using this superposition, images 231 and 236 are stitched, and the new treatment area is now identified by the pattern recognition algorithm, but in the previous step 235 the already treated area is masked. Accordingly, a new scan area 237 is defined and the scan is performed without overlapping with the previous scan (FIG. 23C). The operator then moves the scanner to the middle-left of the area (Fig. 23D). In this case, an overlap with the area 233 of the first image is found compared to the area 239 in the new image. The stitching algorithm defines an area 230 for treatment and a scan is performed (FIG. 23E). In the case of skin, it should be noted that the stitching algorithm depends on the untreated skin, as the treated skin sometimes differs significantly in appearance due to skin whitening (also called frosting) as it is frequent in laser treatment.

When treating the contoured areas, the process can be repeated with an intermediate step of the projection of the camera image into a combined image using the measured curvature data. These algorithms are known to those skilled in the art. It is then easy to combine large and/or contoured treatment areas.

Additionally, based on a predefined set of rules (usually lasers for specific colors), the pattern recognition algorithm has identified specific pigment colors and recommends a therapeutic laser wavelength.

During the main laser scan (see above), which may take several seconds or longer, depending on the size of the tattoo, the subject is able to move. For this reason, the camera can continuously image the treatment area and monitor motion. A motorized optical filter 209 (see FIG. 20) can be used during a treatment scan to block various laser wavelengths so as not to be blinded by reflections from the main laser during scanning.

The illumination sources 206 (FIG. 20) are specially selected LEDs. Some of the LEDs can primarily emit "white" light in the visible range. These are used by the algorithm for pattern recognition of pigment areas. In some embodiments, other LEDs may be specific to the UV range and/or others may be specific to the IR range. Several images can be taken using different illumination sources. UV images extract information about various pigmentations in the skin, but IR images are used to gauge the absorption of IR wavelength lasers.

This system can be integrated with a 6-axis robot to automatically carry out the placement (Figure 24). This can further increase the utilization and accuracy of the system.

Example 6

As clinical trials show, in a laser treatment session, there may be a minimum period of 10 to 20 minutes of subject preparation and post-treatment care. The actual net laser treatment time may be the same or much faster: approximately 20 minutes for tattoos of 200 cm2 area using the system in Example 1 above; Less than about 2 minutes when using the system of Example 5 (200 cm2 is the most common tattoo area to be removed based on clinical trials). This implies low utilization of the laser and system resulting in a lower return on investment.

A solution to alleviate this is a two-treatment room facility according to the invention, supported by a single treatment laser system. Referring to FIG. 25, the system comprises one treatment laser system (with multiple wavelengths) 253, a control unit 254, and two work heads 256, 257 in two treatment rooms 251, 252. (Eg, as described in Example 1 or Example 5), and a motorized flip mirror 255. Each treatment room also includes a treatment chair and everything required to perform the treatment. In this embodiment, the flip mirror, when in place, steers the laser radiation to the workhead in room #1 252. When the flip mirror is out of the optical path, the laser is directed to the second treatment room and scanner head 256. The optical details and flip mirror are well known to those in the art and are not described in detail here. The control unit has the additional control of the flip mirror and can be very similar to those described in Examples 1 or 5. The work head is the same as described in the previous examples: articulated arm, scanner, etc.

As one subject is treated in the first room 252, the second subject may be prepared for treatment in the second room 251. The control unit 254 is operable to receive operator commands from the first room work head 257 while commands from the second room work head 256 are ignored. Once treatment is completed in the first room (signaled by the operator turning off the work head), the controller toggles the flip mirror and bypasses its control commands to be received from the second work head 256. The subject in the second room, now ready to be treated, begins treatment, and the first subject in the first room can receive post-treatment care. The first room is cleaned later, and the next subject is prepared for treatment, so he/she is ready to be treated if the subject in the second room has finished treatment.

The facility layout improves utilization by approximately a factor of two for either the workheads of Example 1 or Example 5. For a system such as that of Example 1, with a 20-minute average treatment time, utilization may exceed 90% as overhead (pre-post-subject care) and treatment times may be similar. Using a scan head similar to that of Example 5 (automated area scanning), since the time for the treatment laser to actually scan is still low (about 4 minutes every 20 to 30 minutes), relatively low utilization still occurs. This will be handled in the following examples.

Yes 7

As discussed in Example 6, it is advantageous to increase the overall utilization, lowered by subject pre- and post-care. The most expensive component in the system is the therapeutic laser. A system for increasing system utilization by a factor of 3 is now described with reference to FIG. 26.

Using a laser capable of pulse energy 3 to 4 times higher than required for treatment (i.e., a laser capable of 10 to 150 mJ), the laser beam is set up to operate independently of three treatment areas 261, 262, 267).

The laser 263 emits a powerful pulse divided by a ratio of 1:2 in energy by a dedicated beam splitter 264. Smaller pulses (one third of the original) propagate to the first treatment room 262. A large pulse (2/3 or original) continues to propagate in the direction of the second beam splitter 265, where it is divided by 1:1 and directed to the second room 261 and the third room 267 at the same time. . Thus, all three treatment rooms receive about 33% of the original pulse energy.

In each treatment room, the laser radiation is individually modulated according to the control signals from each room. This can be achieved, for example, using a Pockel cell optical modulator 266 for the room 267. Thus, the three independent work heads are operative in three distinct areas. The treatment laser 263 operates continuously, so no optical modulator used at its output is required. In practice, this modulator is actually located in each of the three rooms. Unused pulses are emitted at the beam dump and at the end of each optical modulator.

Thus, the utilization of the laser is increased by a factor of three, at the cost of a more expensive laser and three dedicated optical modulators.

For example, it would be obvious to combine this embodiment with the previous one to achieve a six-fold improvement in utilization with a six-room facility.

Example 8

In Example 7 above, a treatment laser with a pulse energy 3 to 4 times higher is divided into three treatment rooms at the same time. Scaling the pulse energy is generally beneficial to reduce the laser downtime, but it is not always the best approach, as laser costs typically rise with the pulse energy. Conversely, increasing the pulse repetition rate (ie, increasing the average power) while maintaining the same pulse energy usually scales more advantageously. This is because increasing the average power entails scaling the pump sources and dealing with the heat load (with a first order approximation), but scaling the pulse energy also entails dealing with the laser induced optical damage to the inner laser surfaces. This is mitigated by scaling the beam area and thus increasing the size and cost of the optical components.

In this example, a treatment room with a single laser and supporting three treatment areas is described. Here a three-fold higher repetition rate, e.g. 600 to 3000 Hz, but a similar pulse energy of 1 to 30 mJ (compared to a single room treatment room laser) is used.

Referring to Fig. 27, the laser room 270 includes the specified treatment laser 271, three high-speed optical modulators (Pokel cell) 273, 274, 275, a control unit 292 and a beam dump 276. Includes. The modulators are usually switched off, allowing the laser output 272 to move unhindered to the beam dump 276. When one of the modulators 273, 274, 275 is turned on, all of the radiation is deflected by about 90 degrees in the direction of the corresponding treatment room. The radiation then reaches the work head in the treatment room.

The modulators are selectively turned on by the control unit 292 at 1/3 of the nominal laser frequency and have a phase of one cycle time between them, which means that the first of the modulators is only one in every three pulses. It can be opened once, meaning that the second of the modulators is opened once for the next pulse and then every third pulse from the second. In fact, the combined modulators down-sample the pulse train from the laser, with each treatment room receiving every first, second or third of every three pulses.

Besides down-sampling, the modulators only steer the pulses when there is a demand for lasing from their corresponding treatment room. A detailed timing diagram is shown in FIG. 28. The laser pulses are depicted as dark rectangles 310, but the x axis represents time. The original pulse train from laser output 272 is shown at 300. Reference numeral 301 denotes a signal from the first treatment room workhead requesting a treatment scan in two separate time periods. At 302, the output of the first modulator 272, which has reached the work head 292 in the treatment room 281, is shown. Upon request from the corresponding work head, it is steered to the first room every third pulse from the laser. The remaining pulses 303 continue in the direction of the second modulator 274. At 304, the requested treatment signal from the second room workhead 279 is shown with pulses deflected by the second modulator 274 in the direction of the second treatment room 278 and eventually to the workhead 279. Reach. Unbiased pulses 305 continue towards the third modulator 275. Numeral 306 represents the requested treatment signal of the third workhead and the resulting pulses reaching the third room. The unbiased pulses 307 eventually reach the beam dump 276 where they are absorbed.

To summarize, the three high-speed optical modulators use a high pulse repetition rate laser to treat three treatment rooms simultaneously and independently, thus achieving high utilization of the laser and generating a good return on investment. Although three modulators are used to steer successive pulses of laser light to the workheads corresponding to the three treatment areas, those skilled in the art have in other embodiments, depending on the original pulse repetition rate of the laser, less Or it will be appreciated that more modulators may be used to selectively steer the beam to two or more treatment rooms.

Computing devices and systems

The computing devices and systems described and/or illustrated in this application broadly represent any type or form of computing device or system capable of executing computer-readable instructions. In their most basic configuration, these computing device(s) may each include at least one memory device and at least one physical processor.

In some examples, the term “memory device” generally refers to any type or form of volatile or non-volatile storage device or medium capable of storing data and/or computer-readable instructions. Examples of memory devices include, without limitation, random access memory (RAM), read-only memory (ROM), flash memory, hard disk drives (HDDs), solid-state drives (SSDs), optical disk drives, Caches, variations or combinations of one or more of these, or any other suitable storage memory.

In some examples, the term “physical processor” generally refers to any type or form of hardware-implemented processing unit capable of interpreting and/or executing computer-readable instructions. Examples of physical processors include, without limitation, microprocessors, microcontrollers, central processing units (CPUs), field-programmable gate arrays (FPGAs) implementing softcore processors, application-specific integrated circuits. (ASICs), one or more portions of this, one or more variations or combinations of these, or any other suitable physical processor.

The process parameters and sequence of steps described and/or illustrated in this application are provided by way of example only and can be changed as desired. For example, the steps illustrated and/or described herein may be shown or discussed in a particular order, but these steps need not necessarily be illustrated or performed in the order discussed. The various representative methods described and/or illustrated in this application may also omit one or more of the steps described or illustrated in this application or include additional steps in addition to those disclosed.

Features from any of the embodiments described in this application may be used in combination with each other according to the general principles described in this application. These and other embodiments, features, and advantages will be more fully understood upon reading the foregoing detailed description in conjunction with the accompanying drawings and claims.

The previous description has been provided to enable any person skilled in the art to utilize the various aspects of the exemplary embodiments disclosed herein. This representative description is not intended to be exhaustive or to be limited to any precise form disclosed. Many modifications and changes are possible without departing from the spirit and scope of this disclosure. The embodiments disclosed herein are illustrative in all respects and should be considered so as not to be limiting. Reference should be made to the appended claims and their equivalents when determining the scope of this disclosure.

References

Anderson, R. R., & Parrish, J. A. (1983). Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science, 220(4596), 524-527.

Goldman, M. P., Fitzpatrick, R. E., Ross, E. V., Kilmer, S. L., & Weiss, R. A. (Eds.). (2013). Lasers and Energy Devices for the Skin (2nd ed.). Taylor & Francis Group, LLC.

Pierce County Emergency Medical Services. (n.d.). Disaster Burn Training. Retrieved May 30, 2019, from Pierce County: https://www.piercecountywa.gov/DocumentCenter/View/3352

Shannon-Missal, L. (2016, February 10). Tattoo Takeover: Three in Ten Americans Have Tattoos, and Most Don’t Stop at Just One. Retrieved from The Harris Poll: https://theharrispoll.com/tattoos-can-take-any-number-of-forms-from-animals-to-quotes-to-cryptic-symbols-and-appear-in-all- sorts-of-spots-on-our-bodies-some-visible-in-everyday-life-others-not-so-much-but-one-thi/

Yarmolenko, P. S. (n.d.). Thresholds of thermal damage and thermal dose models. Retrieved May 31, 2019, from The International Commission on Non-Ionizing Radiation Protection (ICNIRP): https://www.icnirp.org/cms/upload/presentations/Thermo/ICNIRPWHOThermo_2015_Yarmolenko.pdf

Claims (116)

In the method of dermatological treatment,
Irradiating an area of the skin of a subject to be treated with a pulsed beam of laser light; Wherein the laser light has an intensity of at least about 50 GW/cm 2 and a pulse width in the range of about 0.1 to 100 ps. The method according to claim 1,
Wherein the beam of laser light is moved relative to the area to be treated such that successive pulses strike different portions of the area and each portion of the area receives one pulse of the laser light within a single treatment. The method according to claim 2,
The method, wherein the different portions of the area of the skin do not generally overlap each other. The method according to any one of claims 1 to 3,
The method of claim 1, wherein the pulsed laser light has a fluence at an epidermal depth of about 0.5 to 10 J/cm 2. The method according to any one of claims 1 to 4,
The method, wherein the intensity of the laser light allows for the removal of lesions or pigmentation of at least three different colors. The method according to any one of claims 1 to 5,
Wherein the laser light has an intensity of about 0.1 to 1 TW/cm 2. The method according to any one of claims 1 to 6,
Wherein the laser light has a pulse width of at least about 0.5 ps, preferably at least 1.0 ps. The method according to any one of claims 1 to 7,
Wherein the laser light has a pulse width of less than about 35 ps, preferably less than about 25 ps. The method according to any one of claims 1 to 8,
Wherein the laser light has a pulse width in the range of about 1 to 15 ps, preferably about 1 to 10 ps. The method according to any one of claims 1 to 9,
Wherein the laser light has a spot size in the skin of less than about 2 mm in diameter. The method according to any one of claims 1 to 10,
The laser light is about 0.1 to 1.0 mm; Preferably having a spot size of about 0.5 to 1.0 mm. The method according to any one of claims 1 to 11,
The fluence and the spot size of each pulse of the laser light incident on the skin of the subject is in the range of about 0.5 to 10 J/cm 2, and the spot size is The method of claim 1, wherein the skins are controlled to sooth quickly enough after irradiation that they do not experience temperatures higher than 44° C. for longer than a critical duration that causes damage. In the method of dermatological treatment,
Moving the pulsed beam of laser light over an area of the skin of the subject to be treated;
Each pulse impinges on a different portion of the subject's skin within the area to be treated in the form of a spot and the fluence of each pulse at the depth of the epidermis is in the range of about 0.5 to 10 J/cm 2; The method of claim 1, wherein the size of each spot is characterized in that the skins calm down sufficiently quickly so that the skin does not experience a temperature higher than 44° C. for longer than a critical duration that causes damage to the skin. The method according to claim 12 or 13,
Wherein the size of the spot is such that the thermal relaxation time of the skin is shorter than the length of time the skin can withstand an initial temperature rise before damage to the skin is caused. The method according to any one of claims 12 to 14,
Wherein the thermal relaxation time ranges from about 0.1 seconds to about 8 seconds. The method according to any one of claims 12 to 15,
The method of claim 1, wherein the size of the spot generated by the laser light on the skin of the subject is such that the temperature of the skin does not rise above about 51° C. and provides a relaxation time or only about 6 seconds. In the method of dermatological treatment,
Moving the pulsed beam of laser light over an area of the skin of the subject to be treated;
Each pulse impinges on a different portion of the subject's skin within the area to be treated in the form of a spot and the fluence of each pulse at the depth of the epidermis is in the range of about 0.5 to 10 J/cm 2; Wherein each spot has a maximum dimension of less than about 2 mm. The method according to any one of claims 1 to 17,
Wherein the laser light inputs energy pulses in the range of about 1 to 100 mJ into the skin. In the method of coloring removal,
A plurality of successive dermatological treatments in which a pulsed beam of laser light is moved over an area of the subject's skin to be treated such that each pulse impinges on a different portion of the subject's skin within the area to be treated;
Each pulse has a fluence in the range of about 0.5 to 10 J/cm 2 and in the form of a spot small enough so that the skin does not experience temperatures above 44° C. for longer than the critical duration causing damage to the skin. Colliding with the subject's skin; The method, wherein the dermatological treatments are repeated every 1-3 weeks. The method of claim 19,
The method, wherein at most 4 treatments are carried out on the same day, prior to a rest period of 1 to 3 weeks, preferably 1 to 2 weeks. The method according to claim 19 or 20,
Each dermatological treatment is carried out according to any one of claims 1 to 18. The method according to any one of claims 13, 17 or 19 to 21,
The method, wherein the intensity of the laser light is in the range of 10 ⁹ to 10 ¹⁰ W/cm 2. The method according to any one of claims 1 to 22,
The method, wherein laser light of two or more different wavelengths can be used in combination. The method of claim 23,
A method, wherein a first pulsed beam of laser light having an intensity of ^{10 11} to 10 ¹² W/cm 2 is used in combination with a second pulsed beam laser light having an intensity ^{of 10 9} to 10 ^{10 W/cm 2.} The method of claim 24,
Wherein each of the first and second pulsed beams independently has a fluence in the range 0.5-10 J/cm 2. The method of claim 24 or 25,
The first beam is selectively output from a first infrared (IR) laser having a wavelength of 800 nm or 1030 nm, and the second beam is a green laser optionally having a wavelength of 532 nm, or a second IR laser having a wavelength of 1064 nm Output from, how. The method according to any one of claims 1 to 26,
The method, wherein the distinct portions of the area of the skin treated with successive pulses of laser light are separated from each other by at least about 0.1 mm. In the method of dermatological treatment,
Moving the pulsed beam of laser light over an area of the skin of the subject to be treated;
The beam forms a spot of laser light on the skin of the subject and successive pulses hit each of the different portions of the area with fluence at the depth of the epidermis in the range of about 0.5 to 10 J/cm 2, and the portion They are separated from each other by at least about 0.1 mm. The method according to any one of claims 1 to 26,
Wherein the beam of laser light is attenuated in an outer peripheral area such that within each spot the intensity of the beam is lower in the peripheral area. In the method of dermatological treatment,
Each pulse generates a spot of laser light on the subject's skin and irradiating the area of the subject's skin to be treated with a pulsed beam of laser light having a fluence in the range of about 0.5 to 10 J/cm 2 Includes;
Wherein the beam of laser light is moved over the area to be treated such that successive pulses hit different portions of the area, the beam being attenuated such that its intensity is lower in the surrounding outer area than the rest of the beam. The method according to any one of claims 1 to 30,
The method of claim 1, wherein the pulses of laser light are directed to the skin in a pattern comprising a plurality of adjacent rows of spots that are irradiated according to a sequence ensuring that neighboring rows are not continuously irradiated. The method according to any one of claims 1 to 31,
The method, wherein the beam is scanned over the area to be treated. The method of claim 32,
Wherein the scanned beam is scanned across a scanning field by optical beam steering. The method of claim 33,
The shape of the scanning field is adjustable. The method of claim 34,
The method, wherein the shape of the scanning field is selectable from a number of pre-set shapes, such as circular, square and rectangular, optionally having different aspect ratios. The method according to any one of claims 33 to 35,
Further comprising continuously scanning a visible aiming beam around a periphery of the scanning field to show an outline of the scanning field. The method according to any one of claims 33 to 36,
Wherein the beam is scanned across the scanning field with a configurable scanning pattern comprising skipping a portion of the area to be scanned adjacent to the immediately scanned portion and scanning portions further away from the scanned portion and then returning. . The method according to any one of claims 33 to 36,
The beam is scanned across the scanning field such that each pulse of laser light is incident on each different portion of the subject's skin, the beam being scanned in a series of passes across the subject's skin The method, wherein selected, non-adjacent portions are examined in each pass. The method according to any one of claims 33 to 36,
The method, wherein the beam of laser light is scanned across the scanning field in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated. In the method of dermatological treatment,
Each pulse generates a spot of laser light on the subject's skin, and irradiating the area of the subject's skin to be treated with a pulsed beam of laser light having a fluence in the range of about 0.5 to 10 J/cm2. Includes;
The method, wherein the beam of laser light is scanned across the scanning field in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated. The method of claim 39 or 40,
The lines are scanned juxtaposed to each other, each line comprising a plurality of successive pulses of laser light to adjacent portions of the subject's skin. The method of claim 41,
Adjacent lines are scanned consecutively, for example by raster scanning or in an interlaced fashion. The method according to any one of claims 39 to 42,
The portions within each scanned line are examined out of order. The method of claim 43,
Each line is scanned in multiple passes and selected, non-adjacent portions in each of the passes are examined. The method according to any one of claims 33 to 44,
The method, wherein the shape of the scanning field is determined automatically by obtaining the shape of the area to be treated optically, such as by computer vision. The method according to any one of claims 1 to 45,
The pulsed beam is greater than about 30 Hz, preferably greater than about 100 Hz; Optionally having a pulse repetition rate of 200 to 500 Hz. The method according to any one of claims 1 to 46,
Wherein the pulsed beam has a pulse repetition rate of at least about 1000 Hz. In the method of dermatological treatment,
Using the camera to acquire one or more images of at least a portion of the area of the subject's skin to be treated;
Processing the one or more images using image-recognition techniques to determine the shape and size of at least a portion of the area to be treated;
Adjusting the shape and size of the scanning field for the pulsed laser beam according to the determined shape and size of at least a portion of the area to be treated; And
Then scanning the pulsed beam of laser light over the entire scanning field with at least a portion of the area to be treated. The method of claim 48,
Using an image-stitching algorithm to examine successive partially overlapping segments of the area to be treated and to mask the areas of each segment to be treated that overlap with the previously irradiated segments within the same treatment. Processing the one or more images. In the laser device for dermatological treatment,
A work head comprising a camera and a beam scanner for scanning the therapeutic laser beam with a spot size of less than 2 mm across the scanning field of adjustable size and/or shape;
An optical input for connecting the beam scanner to at least one pulse therapy laser;
An adjustable positioning device for stably positioning the work head adjacent to the area of the skin of the subject to be treated; And
It includes an automatic control system for controlling the operation of the laser treatment device,
The automatic control system receives one or more images of the area to be treated from the camera, processes the received images to determine a shape of at least a portion of the area to be treated, and the at least a portion of the area to be treated. The laser device, configured to scan the therapeutic laser beam across the scanning field and adjusting the size and/or shape of the scanning field according to the determined shape. The method of claim 50,
An optical tracer for displaying an outline of the scanning field to an operator on the subject's skin; Wherein the automatic control system is further configured to control the optical tracer to display an outline of the scanning field on the subject's skin. The method of claim 50 or 51,
Further comprising a display adapted to receive from the automatic control system a display signal representing images of at least a portion of the area of the skin of the subject to be treated and display these images on the screen, the automatic control system further comprising the The laser device, configured to display on the screen an outline of a scanning field superimposed on images of a subject's skin. The method of any one of claims 50 to 52,
The automatic control system is configured to wait for a safety control signal after the scanning field is displayed before operating the beam scanner. The method of any one of claims 50 to 53,
Wherein the automatic control system is configured to allow adjustment of the shape and/or size of the scanning field by an operator. The method of any one of claims 50 to 54,
The work head further comprises an aiming beam device for emitting a visible aiming beam toward the skin of the subject to indicate the position of the laser beam scanner with respect to the area to be treated on the skin of the subject. . The method of any one of claims 50 to 55,
Further comprising one or more topography measuring instruments to measure a topography of at least a portion of the area to be treated; The automatic control system may also determine a topography of at least a portion of the area to be treated based on the topography measurements and calculate the shape and/or size of the scanning field. A laser device configured to fuse size and topography. The method of any one of claims 50 to 56,
Wherein the positioning device allows a work head to be placed in a number of different positions to allow treatment of the entire area to be treated in a number of consecutive segments. The method of claim 57,
The automatic control system processes the received images of the segment of the area to be treated to identify an area of overlap with another segment already identified by the control system and calculates the area of overlap in a scanning field for the segment to be treated. A laser device configured to use an image stitching algorithm to mask. The method of any one of claims 50 to 57,
Wherein the positioning device is automated and the automatic control system is further configured to control the positioning device to position the work head to scan consecutive adjacent scanning fields to cover the entire area to be treated. The method of claim 59,
Wherein the automated positioning device is switchable between a first mode in which the work head can be freely moved by an operator and a second mode in which the position of the work head is controlled by the automatic control system. The method of claim 60,
Further comprising one or more topography measuring instruments for measuring a topography of at least a portion of the area to be treated; The automatic control system may also determine a topography of at least a portion of the area to be treated based on the topography measurements and calculate the shape and/or size of the scanning field. Configured to fuse size and topography; The automatic control system allows the robotic arm to continuously measure its position and record its path as the operator has the positioning device in its first mode and directs the workhead around the entire area to be treated. A learning mode in which the camera is operated to continuously capture images of the skin of the subject, and then the automatic control system calculates a scanning path by optimizing the scan path; And the word head being moved under the control of the control system to follow the path created by the control system while operating a beam scanner in continuous scanning fields to scan the pulsed laser beam over the entire area to be treated. Laser device, switchable between scanning modes. The method according to any one of claims 50 to 61,
Further comprising one or more motion detectors for detecting and measuring motion of the subject during treatment; Wherein the automatic control system is configured to automatically correct the scanning of the therapeutic laser beam or to stop scanning if the motion exceeds a threshold amount. The method of any one of claims 51 to 62,
The laser device further comprising a pulsed therapy laser and an optical system for coupling the therapy laser to an optical input of the workhead. The method of claim 63,
The laser apparatus, wherein the pulsed laser beam emitted by the beam scanning device has a pulse width in the range of about 0.1 to 100 ps and an intensity of at least about 50 GW/cm 2. In the laser device for dermatological treatment,
A pulsed treatment laser, a work head for delivering a pulsed beam of laser light to an area of the skin of a subject to be treated, and an optical system for connecting the treatment laser to the work head; The arrangement such that the pulsed laser beam has a pulse width in the range of about 0.1-100 ps and an intensity of at least about 50 GW/cm 2. The method of claim 64 or 65,
The laser device, wherein the pulsed laser light has a fluence at a skin depth of about 0.5 to 10 J/cm 2, preferably about 1 to 8 J/cm 2. The method of any one of claims 64 to 66,
The laser device, wherein the laser light has an intensity of about 0.1 to 1 TW/cm 2. The method of any one of claims 64 to 67,
The laser device, wherein the laser light has a pulse width of at least about 0.5 ps, preferably at least 1.0 ps. The method of any one of claims 64 to 68,
The laser device, wherein the laser light has a pulse width of less than about 35 ps, preferably less than about 25 ps. The method of any one of claims 64 to 69,
Wherein the laser light has a pulse width in the range of about 1 to 15 ps, preferably about 1 to 10 ps. The method of any one of claims 64 to 70,
The laser device, wherein the laser light has a spot size in the skin of about 2 mm or less in diameter. The method of any one of claims 64 to 71,
The laser light is about 0.1 to 2.0 mm; Preferably having a spot size of about 0.5 to 1.0 mm, the work-head comprises a beam scanner for scanning the pulsed beam of the laser light such that each pulse impinges on a different portion of the skin of the subject. , Laser device. In the laser device for dermatological treatment,
A work-head comprising a pulsed therapy laser, a beam scanner for scanning a pulsed beam of laser light into an area of the subject's skin to be treated such that each pulse strikes a different portion of the subject's skin, and the beam An optical system for coupling the therapeutic laser to a scanner, the arrangement wherein each pulse during use is about 0.1 to 2.0 mm by the beam scanner; Preferably, it is delivered to the skin of the subject in the form of a spot having a maximum dimension in the range of about 0.5 to 1.0 mm, and the fluence of each pulse at the depth of the epidermis is in the range of about 0.5 to 10 J/cm 2 To do, the laser device. The method of claim 73,
Wherein the beam scanning device is configured such that different portions of the area of the skin treated with successive pulses of laser light are separated from each other by at least about 0.1 mm. In the laser device for dermatological treatment,
A work-head comprising a pulsed therapy laser, a beam scanner for scanning a pulsed beam of laser light into an area of the subject's skin to be treated such that each pulse strikes a different portion of the subject's skin, and the beam And an optical system for connecting the therapeutic laser to a scanning device, the arrangement wherein each pulse during use has a fluence at a depth of the skin in the range of about 0.5 to 10 J/cm 2 by the beam scanner and a spot The laser device is delivered to the skin of the subject in the form of and the different parts are separated from each other by at least about 0.1 mm. In the laser device for dermatological treatment,
Pulse therapy laser, a work-head comprising a beam scanner for scanning a pulsed beam of laser light into an area of the skin of the subject to be treated so that each pulse strikes a different portion of the skin of the subject, and scanning the beam An optical system for connecting the therapeutic laser to a device, the arrangement wherein each pulse during use has a fluence at a depth of the skin in the range of about 0.5-10 J/cm 2 by the beam scanner and the spot Wherein the laser device is configured to be delivered to the subject's skin in a form wherein the beam is attenuated such that its intensity is lower in the surrounding outer area than the rest of the beam. The method of any one of claims 73 to 75,
Wherein the beam scanner comprises an optical beam steering device for scanning the beam across a scanning field. The method of claim 77,
The shape of the scanning field is adjustable, laser device. The method of claim 78,
The shape of the scanning field is optionally selectable from a number of pre-set shapes, eg circular, square and rectangular, with different aspect ratios. The method of any one of claims 77 to 79,
The laser apparatus further comprising an aiming beam device for continuously scanning a visible aiming beam around a periphery of the scanning field to outline the scanning field. The method according to any one of claims 77 to 80,
The beam scanner spans the scanning field with a configurable scanning pattern comprising skipping a portion of the scanned area adjacent to the portion where the beam has just been scanned and scanning portions further away from the scanned portion and then returning. A laser device configured to be scanned. The method of any one of claims 77-81,
Wherein the beam scanner is configured such that the beam is scanned across the scanning field in a sequence of passes and selected, non-adjacent portions of the area to be treated in each of the passes are irradiated. The method of any one of claims 77-82,
Wherein the beam scanner is configured to scan the beam of laser light across the scanning field in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated. In the laser device for dermatological treatment,
A pulsed treatment laser, a work-head comprising a beam scanner for scanning a pulsed beam of laser light into an area of the subject's skin to be treated, and an optical system for connecting the treatment laser to the beam scanner; The arrangement allows each pulse during use to be delivered to the subject's skin in the form of a spot with a fluence at the epidermal depth in the range of about 0.5 to 10 J/cm 2 by the beam scanner. Wherein the beam of laser light is configured to be scanned over a scanning field in a series of linear or curved lines such that successive pulses hit different portions of the area to be treated. The method of claim 83 or 84,
The lines are scanned parallel to each other, each line comprising a plurality of successive pulses of the laser light to adjacent portions of the subject's skin. The method of claim 85,
Adjacent lines are scanned in succession, eg by raster scanning. The method of claim 85,
The lines are scanned in an interlacing manner. The method of any one of claims 83 to 87,
The laser device, wherein portions within each scanned line are irradiated out of sequence. The method of claim 88,
Each line is scanned in a sequence of passes and selected, non-adjacent portions in each of the passes are irradiated. The method of any one of claims 83 to 89,
The laser device, wherein the shape of the scanning field is determined automatically by obtaining the shape of the area to be treated by optics, for example computer vision. The method according to any one of claims 64 to 90,
The pulsed beam is greater than about 30 Hz, preferably greater than about 100 Hz; Optionally, a laser device having a pulse repetition rate of 200 to 500 Hz. The method of any one of claims 64 to 91,
The laser device, wherein the pulsed beam has a pulse repetition rate of at least about 1000 Hz, such as 2000 Hz, 4000 Hz or 6000 Hz. The method of any one of claims 64 to 92,
Each pulse has an energy in the range of about 1 to 100 mJ, preferably about 1 to 50 mJ, more preferably about 1 to 30 mJ. The method of any one of claims 64 to 93,
A laser device comprising two or more pulsed therapy lasers having different wavelengths connected to the work head. The method of claim 94,
The arrangement is ^{a first beam having an intensity of 10 11} to 10 ¹² W/cm 2 from the first pulse treatment laser and a first beam having an intensity of 10 ⁹ to 10 ¹⁰ W/cm 2 from the second pulse treatment laser during use. 2 to deliver a beam to the area to be treated. The method of claim 95,
Each of the first and second pulsed beams independently has a fluence in the range 0.5 to 10 J/cm 2, preferably 1 to 7 J/cm 2 or 1 to 8 J/cm 2. The method of claim 95 or 96,
The first laser is optionally an IR laser having a wavelength of 800 nm or 1030 nm, the second laser is a green laser optionally having a wavelength of 532 nm, or another IR laser having a wavelength of 1064 nm, laser device. The method of any one of claims 64 to 81,
Wherein the beam of laser light is attenuated in an outer peripheral area such that the intensity of the beam within each spot is lower in the peripheral area. The method of any one of claims 64 to 98,
The laser device, wherein the laser is a mode-locked laser. The method of any one of claims 64 to 99,
The laser device further comprising one or more motion detectors for detecting and measuring motion of the subject or work head during treatment, and an automatic control system configured to stop the operation of the laser if the motion exceeds a threshold amount. . In the dermatology laser treatment facility,
A pulsed therapy laser operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz; A plurality of distinct treatment areas; The laser treatment device at each treatment area, wherein each laser treatment device comprises a beam scanner for scanning the treatment laser beam over an area of the skin of the subject to be treated and a work head including an optical input. Device; And an optical system for coupling the treatment laser to an optical input of a work head of each laser treatment device;
Wherein the optical system includes a photo-machine selector operable to selectively steer the laser beam to any of the laser treatment devices. The method of claim 101,
Each pulse has an energy of about 1 to 100 mJ, a dermatological laser treatment facility. In the dermatology laser treatment facility,
A pulsed therapy laser operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz; A plurality of distinct treatment areas; A laser treatment device at each treatment area, wherein the laser treatment device has a spot size of less than 2 mm over an area of the skin of a subject to be treated and a work head comprising a beam scanner and an optical input for scanning the treatment laser beam Including, the laser treatment device; And an optical system for coupling the pulsed therapy laser to an optical input of a work head of each laser therapy device;
Wherein the optical system comprises a passive optical splitter for splitting the beam and directing it simultaneously to each of the laser treatment devices. The method of claim 103,
The pulse treatment laser has a pulse energy of at least 5 mJ, dermatological laser treatment equipment. The method of claim 103 or 104,
A dermatological laser treatment facility, wherein the beam scanner at each workhead comprises a high speed optical modulator for modulating the segmented laser beam according to the specific requirements of each separate treatment area. The method according to any one of claims 103 to 105,
The beam is split between two laser treatment devices/treatment areas. In the dermatology laser treatment facility,
A pulsed therapy laser operable to generate a beam of laser light having a pulse repetition rate of at least 30 Hz; A plurality (n) of distinct treatment areas; A laser treatment device at each treatment area, wherein each laser treatment device has a spot size of less than 2 mm over an area of the skin of the subject to be treated and includes a beam scanner for scanning the treatment laser beam and an optical input. The laser treatment device, including a head; And an optical system for coupling the pulsed therapy laser to an optical input of each laser therapy device;
The optical system is arranged in series and has each optical modulator taking every nth pulse, equal to the number of treatment areas of optical modulators selectively operable to steer successive pulses in turn with different ones of the laser treatment devices. Dermatological laser treatment equipment comprising a plurality (n). The method of claim 106,
The pulse therapy laser has a pulse repetition rate of more than 100 Hz, preferably more than 500 Hz and more preferably more than 1000 Hz, for example 2000 Hz, 4000 Hz or 6000 Hz. The method of claim 107 or 108,
Each pulse should have an energy of about 1 to 100 mJ, a dermatological laser treatment facility. The method according to any one of claims 107 to 109,
A dermatological laser treatment facility, wherein the beam scanner of each laser treatment device comprises an optical modulator for modulating the pulses with a pulse duration providing fluence at a depth of the skin in the range of about 0.5 to 10 J/cm 2. In the test device for testing the correct operation of the work head of the dermatology laser treatment device,
A support structure having a work head fastening portion configured to engage a corresponding fastening portion on the work head and one or more sensors for testing one or more properties of the work head,
The one or more sensors are fixed to the support structure at a position spaced apart from the work head fastening part, and the work head fastening part is the corresponding fastening on the work head to stably position the work head with respect to the sensors. A test device that is configured to engage a part. The method of claim 111,
The one or more sensors include at least one position sensitive sensor for detecting the position and power of the beam of laser light emitted by the work head. The method of claim 111 or 112,
And a perforated separator plate interposed between the work head fastening portion and the at least one sensor; The separator plate is formed with one or more holes extending therethrough at known positions relative to the work head fastening portion, the rest of the separator plate being opaque to the laser light emitted by the work head; The work head fastening portion is adapted to cooperate with the corresponding fastening portion on the work head to position the work head in a known position relative to the separator plate; Wherein the one or more sensors comprise one or more optical power sensors on the opposite side of the separator plate from the work head to detect light that has correctly passed through the one or more holes. The method of claim 113,
Wherein the separator plate is formed with a plurality of holes of different sizes for measuring the divergence of the beam emitted by the work head. The method of any one of claims 111 to 114,
The test apparatus, wherein the one or more sensors comprise at least one optical power meter. The method of any one of claims 111 to 115,
And at least one spacer detachably connectable to the corresponding fastening part on the work head to separate the work head from the skin of the subject during use, and between the one or more sensors and the work head fastening part The distance is approximately equal to the length of the spacer, the test apparatus.

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